Basic Information
Provider Information
NPI: 1417960998
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CUNNINGHAM
FirstName: FRANCIS
MiddleName: GARY
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 845347
Address2:  
City: DALLAS
State: TX
PostalCode: 752845347
CountryCode: US
TelephoneNumber: 2146487250
FaxNumber:  
Practice Location
Address1: 5323 HARRY HINES BLVD
Address2:  
City: DALLAS
State: TX
PostalCode: 753907208
CountryCode: US
TelephoneNumber: 2146487250
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/14/2006
LastUpdateDate: 05/29/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000XE1547TXN Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 
207VM0101XE1547TXY Allopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine

ID Information
IDTypeStateIssuerDescription
13928961305TX MEDICAID


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