Provider Demographics
NPI:1851616924
Name:CUNNINGHAM CHIROPRACTIC, P.C.
Entity Type:Organization
Organization Name:CUNNINGHAM CHIROPRACTIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:N
Authorized Official - Last Name:CUNNINGHAM
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:806-293-3130
Mailing Address - Street 1:2204 EDGEMERE DR
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:79072-3754
Mailing Address - Country:US
Mailing Address - Phone:806-293-3130
Mailing Address - Fax:806-293-3747
Practice Address - Street 1:2204 EDGEMERE DR
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:TX
Practice Address - Zip Code:79072-3754
Practice Address - Country:US
Practice Address - Phone:806-293-3130
Practice Address - Fax:806-293-3747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-01
Last Update Date:2010-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2691111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0011017-01Medicaid
TX600966Medicare PIN
TXT12860Medicare UPIN