Basic Information
| Provider Information | |||||||||
| NPI: | 1326049966 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CUNNINGHAM | ||||||||
| FirstName: | JAYKAY | ||||||||
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| Credential: | P.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3803 FM 1092 RD | ||||||||
| Address2: | |||||||||
| City: | MISSOURI CITY | ||||||||
| State: | TX | ||||||||
| PostalCode: | 774592209 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2814038271 | ||||||||
| FaxNumber: | 2814038274 | ||||||||
| Practice Location | |||||||||
| Address1: | 1211 HIGHWAY 6 | ||||||||
| Address2: | SUITE 1 | ||||||||
| City: | SUGAR LAND | ||||||||
| State: | TX | ||||||||
| PostalCode: | 774784941 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2814944832 | ||||||||
| FaxNumber: | 2814947399 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/04/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | PA02518 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.