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NPI Code Detail

MEDICARE: DONNA NATIVIDAD CANLAS MD

MEDICARE: DONNA NATIVIDAD CANLAS MD
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
1207Q00000XFamily Medicine PhysicianK3119TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
310030907OTHERTXAMERIGROUP
40049KAOTHERTXBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1205026242
Entity Type Code : Individual
Provider Name (Legal Business Name) : DONNA NATIVIDAD CANLAS MD
Provider Business Mailing Address
First Line : 4615 SOUTHWEST FWY
Second Line : SUITE 850
City : HOUSTON
State : TX
Zip : 77027-7162
Country : US
Telephone Number : 713-291-3426
Fax Number : 832-767-2314
Provider Business Practice Location Address
First Line : 4615 SOUTHWEST FWY
Second Line : SUITE 850
City : HOUSTON
State : TX
Zip : 77027-7162
Country : US
Telephone Number : 713-291-3426
Fax Number : 832-767-2314
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2007
Last Update Date : 11/25/2019

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