MEDICARE: SAMUEL CUNNINGHAM M.D., PH.D

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	207Y00000X	Otolaryngology Physician	M3507	TX

General Provider Information

NPI Number	:	1437193307
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMUEL CUNNINGHAM M.D., PH.D

Provider Business Mailing Address
First Line	:	6830 PLUM CREEK DR
Second Line	:
City	:	AMARILLO
State	:	TX
Zip	:	79124-1601
Country	:	US
Telephone Number	:	806-355-9999
Fax Number	:	806-355-9989

Provider Business Practice Location Address
First Line	:	6830 PLUM CREEK DR
Second Line	:
City	:	AMARILLO
State	:	TX
Zip	:	79124-1601
Country	:	US
Telephone Number	:	806-355-9999
Fax Number	:	806-355-9989

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

Provider Enumeration Date	:	06/15/2006
Last Update Date	:	01/20/2025

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