Provider Demographics
NPI:1285783381
Name:FRANK P. CUNDARI,D.O., P.A.
Entity type:Organization
Organization Name:FRANK P. CUNDARI,D.O., P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:P
Authorized Official - Last Name:CUNDARI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:972-647-8835
Mailing Address - Street 1:647 S GREAT SOUTHWEST PKWY
Mailing Address - Street 2:SUITE #101
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75051-1058
Mailing Address - Country:US
Mailing Address - Phone:972-647-8835
Mailing Address - Fax:972-641-6319
Practice Address - Street 1:647 S GREAT SOUTHWEST PKWY
Practice Address - Street 2:SUITE #101
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75051-1058
Practice Address - Country:US
Practice Address - Phone:972-647-8835
Practice Address - Fax:972-641-6319
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF3439207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXA66074Medicare UPIN
TX00L55GMedicare ID - Type Unspecified