MEDICARE: DR. WYNTREA LANEICE CUNNINGHAM M.D., M.P.H.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	R3303	TX

General Provider Information

NPI Number	:	1649513136
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WYNTREA LANEICE CUNNINGHAM M.D., M.P.H.

Provider Business Mailing Address
First Line	:	7707 FANNIN ST STE 110
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77054-1918
Country	:	US
Telephone Number	:	346-571-1147
Fax Number	:	832-831-2196

Provider Business Practice Location Address
First Line	:	7707 FANNIN ST STE 110
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77054-1918
Country	:	US
Telephone Number	:	346-571-1147
Fax Number	:	832-831-2196

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/03/2013
Last Update Date	:	04/05/2022

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