Healthcare Provider Details

I. General information

NPI: 1568559730
Provider Name (Legal Business Name): FELIX HELIO CANO DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

434 HIGHWAY 199 EAST
SPRINGTOWN TX
76082
US

IV. Provider business mailing address

PO BOX 19
SPRINGTOWN TX
76082-0069
US

V. Phone/Fax

Practice location:
  • Phone: 817-523-5963
  • Fax: 817-220-5963
Mailing address:
  • Phone: 817-523-5963
  • Fax: 817-220-5963

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number17179
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: