Provider Demographics
NPI:1396850798
Name:CUNNINGHAM-FARBSTEIN, JENNIFER LORI (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:LORI
Last Name:CUNNINGHAM-FARBSTEIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8403 LORRIE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77025-3236
Mailing Address - Country:US
Mailing Address - Phone:713-397-6936
Mailing Address - Fax:866-459-2296
Practice Address - Street 1:8403 LORRIE DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77025-3236
Practice Address - Country:US
Practice Address - Phone:713-397-6936
Practice Address - Fax:866-459-2296
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2016-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL7700207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00719209OtherRR MEDICARE
TX197985801Medicaid
TXP00719209OtherRR MEDICARE
TX149466Medicare UPIN