Individual
DONNA NATIVIDAD CANLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4615 SOUTHWEST FWY, SUITE 850, HOUSTON, TX 77027-7162
(713) 291-3426
(832) 767-2314
Mailing address
4615 SOUTHWEST FWY, SUITE 850, HOUSTON, TX 77027-7162
(713) 291-3426
(832) 767-2314
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
K3119
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0049KA
BLUE CROSS BLUE SHIELD
TX
01
—
10030907
AMERIGROUP
TX
05
—
124504507
—
TX
05
—
124504508
—
TX
Enumeration date
07/26/2007
Last updated
11/25/2019
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