Healthcare Provider Details

I. General information

NPI: 1881650547
Provider Name (Legal Business Name): MELINDA ANITA CANO-HOWES OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2006
Last Update Date: 08/21/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1603 MAIN STREET, SW SUITE B
LOS LUNAS NM
87031
US

IV. Provider business mailing address

8801 HORIZON BLVD NE SUITE 360
ALBUQUERQUE NM
87113-1533
US

V. Phone/Fax

Practice location:
  • Phone: 505-865-6100
  • Fax: 505-213-0103
Mailing address:
  • Phone: 505-828-4923
  • Fax: 505-213-0103

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number514
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: