MEDICARE: BERNABE BRADEN CANLAS DPM

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	213E00000X	Podiatrist	1678	TX

General Provider Information

NPI Number	:	1417926999
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BERNABE BRADEN CANLAS DPM

Provider Business Mailing Address
First Line	:	PO BOX 58538
Second Line	:
City	:	WEBSTER
State	:	TX
Zip	:	77598-8538
Country	:	US
Telephone Number	:	281-334-5032
Fax Number	:	281-334-3932

Provider Business Practice Location Address
First Line	:	3023 MARINA BAY DR STE 106
Second Line	:
City	:	LEAGUE CITY
State	:	TX
Zip	:	77573-2882
Country	:	US
Telephone Number	:	281-334-5032
Fax Number	:	281-334-3932

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

Provider Enumeration Date	:	03/16/2006
Last Update Date	:	06/02/2025

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