Provider Demographics
NPI:1114110897
Name:CUNNINGHAM, BRIAN DANIEL (DC)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:DANIEL
Last Name:CUNNINGHAM
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4208 VIRGINIA CT
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-6624
Mailing Address - Country:US
Mailing Address - Phone:214-907-6711
Mailing Address - Fax:
Practice Address - Street 1:401 ADRIATIC PKWY
Practice Address - Street 2:200
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-5531
Practice Address - Country:US
Practice Address - Phone:214-907-6711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-24
Last Update Date:2012-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8283111N00000X
NC2584111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor