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General NPI Number Information
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NPI Number | 1922297670
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Entity Type | Organization
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Legal Business Name | PAMELA S. CUNNINGHAM, M.D., P.A.
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Dates
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Enumeration Date | 10/18/2007
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Last Update Date | 05/16/2011
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Provider Practice Location Address
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Address Line | 600 N GRANT AVE SUITE 200
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City | ODESSA
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State | TX
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Zip | 79761-4503
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Country | US
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Telephone | 432-331-1234
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1808
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City | ODESSA
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State | TX
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Zip | 79760-1808
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | PAMELA CUNNINGHAM
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Credential |
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Telephone | 432-331-1234
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | M0387
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License Number State | TX
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