Individual
STEPHANIE PRINCE CUNNINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
2875 JIMMY JOHNSON BLVD STE 100, PORT ARTHUR, TX 77640-2002
(409) 729-9222
(409) 722-9425
Mailing address
2875 JIMMY JOHNSON BLVD STE 100, PORT ARTHUR, TX 77640-2002
(409) 729-9222
(409) 722-9425
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
K1285
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003853
—
TX
01
—
092341901
TPI
TX
01
—
10589293
CAQH
TX
01
—
4133871
BLUELINK
TX
Enumeration date
09/27/2006
Last updated
01/05/2016
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