Provider Demographics
NPI:1821211046
Name:CUNNINGHAM, INA C (PT)
Entity Type:Individual
Prefix:
First Name:INA
Middle Name:C
Last Name:CUNNINGHAM
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:923 PASADENA FWY
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77506-1400
Mailing Address - Country:US
Mailing Address - Phone:713-475-8686
Mailing Address - Fax:
Practice Address - Street 1:923 PASADENA FWY
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77506-1400
Practice Address - Country:US
Practice Address - Phone:713-475-8686
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2013-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1164593225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist