Healthcare Provider Details

I. General information

NPI: 1073924767
Provider Name (Legal Business Name): DONALD CUMMINGS CP, LP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2014
Last Update Date: 02/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2222 WELBORN ST
DALLAS TX
75219-3924
US

IV. Provider business mailing address

2222 WELBORN ST
DALLAS TX
75219-3924
US

V. Phone/Fax

Practice location:
  • Phone: 214-559-7440
  • Fax: 214-559-7473
Mailing address:
  • Phone: 214-559-7440
  • Fax: 214-559-7473

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224P00000X
TaxonomyProsthetist
License Number402
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: