Provider Demographics
NPI:1720285471
Name:CUNNINGHAM, GAIL L
Entity Type:Individual
Prefix:
First Name:GAIL
Middle Name:L
Last Name:CUNNINGHAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2254 COUNTY ROAD 179
Mailing Address - Street 2:
Mailing Address - City:ALVIN
Mailing Address - State:TX
Mailing Address - Zip Code:77511-7082
Mailing Address - Country:US
Mailing Address - Phone:713-734-5770
Mailing Address - Fax:713-734-6926
Practice Address - Street 1:2254 COUNTY ROAD 179
Practice Address - Street 2:
Practice Address - City:ALVIN
Practice Address - State:TX
Practice Address - Zip Code:77511-7082
Practice Address - Country:US
Practice Address - Phone:713-734-5770
Practice Address - Fax:713-734-6926
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor