MEDICARE: DR. YOVANI ALEXANDER CANALES PHARM. D.

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	183500000X	Pharmacist	63178	TX

General Provider Information

NPI Number	:	1396345567
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. YOVANI ALEXANDER CANALES PHARM. D.

Provider Business Mailing Address
First Line	:	5614 BERRY CREEK DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77017-6802
Country	:	US
Telephone Number	:	832-659-4557
Fax Number	:

Provider Business Practice Location Address
First Line	:	11101 FUQUA ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77089-2508
Country	:	US
Telephone Number	:	713-378-9584
Fax Number	:

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

Provider Enumeration Date	:	10/27/2020
Last Update Date	:	10/27/2020

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