Cunningham, Derek N.

Cunningham, Derek N. is an individual health care provider with primary practice located at 901 Mopac Expressway South Building 4 Suite 350, Austin TX 78746-5776. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Cunningham, Derek N. can be contacted via phone (512) 347-0255.

Contact Information

Primary practice address
901 Mopac Expressway South Building 4 Suite 350 Austin TX 78746-5776
Phone: (512) 347-0255
Fax: (512) 347-0785
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X R164TA776 Alabama
Eye and Vision Services Providers / Optometrist 152W00000X 06300T Texas

Profile Details

NPI number 1265407084
LBN Legal business name Cunningham, Derek N.
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 23rd, 2006
Last updated Oct 21st, 2014 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265407084 NPPES
Texas MEDICAID 166400501

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