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NPI Code Detail

MEDICARE: DANIEL CANALES ESTRADA MSN, NP-C

MEDICARE: DANIEL CANALES ESTRADA MSN, NP-C
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
1363LF0000XFamily Nurse PractitionerAP128249TX

General Provider Information

NPI Number : 1629453006
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIEL CANALES ESTRADA MSN, NP-C
Provider Business Mailing Address
First Line : 7401 LAKE BUCHANAN CT
Second Line :
City : CORPUS CHRISTI
State : TX
Zip : 78413-5162
Country : US
Telephone Number : 361-558-5697
Fax Number :
Provider Business Practice Location Address
First Line : 1627 WILDCAT DR
Second Line :
City : PORTLAND
State : TX
Zip : 78374-2815
Country : US
Telephone Number : 361-643-1552
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/27/2015
Last Update Date : 07/27/2015

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