MEDICARE: MELISSA CANALES PA-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
1	363A00000X	Physician Assistant	PA05552	TX

General Provider Information

NPI Number	:	1851535017
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA CANALES PA-C

Provider Business Mailing Address
First Line	:	5401 FM 1626
Second Line	:	STE. 100D
City	:	KYLE
State	:	TX
Zip	:	78640-6038
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5401 FM 1626
Second Line	:	STE. 100D
City	:	KYLE
State	:	TX
Zip	:	78640-6038
Country	:	US
Telephone Number	:	512-268-1940
Fax Number	:

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

Provider Enumeration Date	:	04/30/2009
Last Update Date	:	08/11/2009

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Directions to “ MELISSA CANALES PA-C” Practice Location

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