Eddie Otto Cunningham
Occupational Therapy Assistant
5316 Trail Lake Dr
Fort Worth
, Texas 76133-1931
Eddie Otto Cunningham
Occupational Therapy Assistant
5316 Trail Lake Dr
Fort Worth
, Texas 76133-1931
(817) 789-6489
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About
Features
Specialties
- Occupational Therapy Assistant
Languages spoken
- English
Location
First Address
- Eddie Otto Cunningham
- 5316 Trail Lake Dr
- Fort Worth, TX
- Zip : 76133-1931
- Fax : (817) 789-6489
- Phone : (817) 292-8787
Second Address
- Eddie Otto Cunningham
- 5316 Trail Lake Dr
- Fort Worth, TX
- Zip : 76133-1931
- Fax : (817) 789-6489
- Phone : (817) 292-8787
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 224Z00000X | Occupational Therapy Assistant | 207985 | TX |
National Provider Identifier
| NPI | 1003196627 |
|---|---|
| Provider Name | Eddie Otto Cunningham |
| First Address | Fort Worth, TX 76133-1931 |
| Second Address | Fort Worth, TX 76133-1931 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 26/08/2011 |
| Last Update Date | 26/08/2011 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 149984001 | (05) | TX |
| 207164901 | (05) | TX |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.