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General NPI Number Information
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NPI Number | 1750842357
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Entity Type | Individual
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Provider Name | CANON CROFT CORNELIUS MD
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Gender | Male
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Dates
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Enumeration Date | 03/26/2019
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Last Update Date | 05/05/2025
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Provider Practice Location Address
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Address Line | 9301 N CENTRAL EXPY STE 500
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City | DALLAS
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State | TX
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Zip | 75231-0805
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Country | US
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Telephone | 214-220-2468
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Fax | 469-232-9738
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Provider Business Mailing Address
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Address Line | 4700 SETON CENTER PKWY STE 115
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City | AUSTIN
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State | TX
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Zip | 78759-5753
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Country | US
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Telephone | 346-440-0645
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Fax | 346-478-0182
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | U9238
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207XX0004X
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Taxonomy Name | Orthopaedic Foot and Ankle Surgery Physician
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License Number | U9238
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License Number State | TX
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