Provider Demographics
NPI:1487665881
Name:CUNNINGHAM, WENDY (DC)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:CUNNINGHAM
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3715 DRY CREEK DR
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77505-4193
Mailing Address - Country:US
Mailing Address - Phone:281-487-7545
Mailing Address - Fax:
Practice Address - Street 1:6429 FAIRMONT PKWY STE 102
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77505-4220
Practice Address - Country:US
Practice Address - Phone:281-487-2828
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6285111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX605472Medicare ID - Type Unspecified
TXU62082Medicare UPIN