Provider Demographics
NPI:1841357423
Name:DIANA P. CUNNINGHAM,PH.D. INC
Entity type:Organization
Organization Name:DIANA P. CUNNINGHAM,PH.D. INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:PINSON
Authorized Official - Last Name:CUNNINGHAM
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:972-907-9129
Mailing Address - Street 1:2007 N COLLINS BLVD
Mailing Address - Street 2:401
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-2658
Mailing Address - Country:US
Mailing Address - Phone:972-907-9129
Mailing Address - Fax:972-380-8262
Practice Address - Street 1:2007 N COLLINS BLVD
Practice Address - Street 2:401
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-2658
Practice Address - Country:US
Practice Address - Phone:972-907-9129
Practice Address - Fax:972-380-8262
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX22371103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00J88PMedicare PIN