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NPI Code Detail

MEDICARE: DR. LYNAE S. CANALES MD

MEDICARE: DR. LYNAE S. CANALES 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
1208000000XPediatrics PhysicianL4278TX

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2510361YRWWOTHERTXMEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1851383202
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LYNAE S. CANALES MD
Provider Business Mailing Address
First Line : 3533 SOUTH ALAMEDA # 303
Second Line : J M SLOAN MEDICAL CENTER
City : CORPUS CHRISTI
State : TX
Zip : 78411-1721
Country : US
Telephone Number : 361-853-3222
Fax Number : 361-853-7311
Provider Business Practice Location Address
First Line : 3533 S ALAMEDA ST
Second Line : #303, JOSEPH M. SLOAN BLDG.
City : CORPUS CHRISTI
State : TX
Zip : 78411-1721
Country : US
Telephone Number : 361-853-3222
Fax Number : 361-561-2692
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/21/2005
Last Update Date : 07/01/2020

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