Provider Demographics
NPI:1679291298
Name:CUNNINGHAM, EMMALEA RYAN (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:EMMALEA
Middle Name:RYAN
Last Name:CUNNINGHAM
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 SATELLITE VW APT 13211
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78665-2087
Mailing Address - Country:US
Mailing Address - Phone:903-644-6030
Mailing Address - Fax:
Practice Address - Street 1:1320 ARROW POINT DR STE 413
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-2095
Practice Address - Country:US
Practice Address - Phone:512-260-6990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-19
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1360030225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist