Healthcare Provider Details

I. General information

NPI: 1962134205
Provider Name (Legal Business Name): MD ON DELIVERY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2022
Last Update Date: 06/27/2022
Certification Date: 06/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2123 JUDIWAY ST
HOUSTON TX
77018-5834
US

IV. Provider business mailing address

2123 JUDIWAY ST
HOUSTON TX
77018-5834
US

V. Phone/Fax

Practice location:
  • Phone: 832-477-2234
  • Fax:
Mailing address:
  • Phone: 832-477-2234
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207YX0602X
TaxonomyOtolaryngic Allergy Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207YP0228X
TaxonomyPediatric Otolaryngology Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State

VIII. Authorized Official

Name: KARINA CANADAS
Title or Position: PHYSICIAN/OWNER
Credential: MD
Phone: 315-395-4465