Healthcare Provider Details

I. General information

NPI: 1093368177
Provider Name (Legal Business Name): ANNETTE MARIE CANO SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2019
Last Update Date: 07/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 GESSNER RD STE 190
HOUSTON TX
77080-3844
US

IV. Provider business mailing address

2600 GESSNER RD STE 190
HOUSTON TX
77080-3844
US

V. Phone/Fax

Practice location:
  • Phone: 713-996-7996
  • Fax:
Mailing address:
  • Phone: 713-996-7996
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number115004
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: