Individual
MATTHEW PATRICK CANESTRARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3100 MONTICELLO AVE # 210, DALLAS, TX 75205-3442
(817) 529-8514
(469) 453-5075
Mailing address
3100 MONTICELLO AVE # 210, DALLAS, TX 75205-3442
(817) 529-8514
(469) 453-5075
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
999999999
NOT APPLICABLE
—
Enumeration date
04/14/2021
Last updated
04/14/2021
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