MEDICARE: TATIANNA CANADY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1744P3200X	Prosthetics Case Management

General Provider Information

NPI Number	:	1073173696
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TATIANNA CANADY

Provider Business Mailing Address
First Line	:	7300 MAGNOLIA PKWY APT 4102
Second Line	:
City	:	PEARLAND
State	:	TX
Zip	:	77584-5294
Country	:	US
Telephone Number	:	810-597-7141
Fax Number	:

Provider Business Practice Location Address
First Line	:	7300 MAGNOLIA PKWY APT 4102
Second Line	:
City	:	PEARLAND
State	:	TX
Zip	:	77584-5294
Country	:	US
Telephone Number	:	810-597-7141
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/17/2019
Last Update Date	:	02/17/2026

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Directions to “ TATIANNA CANADY ” Practice Location

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