Individual
MITRA HAGHIRI-CANALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1600 WALLACE BLVD, AMARILLO, TX 79106-1789
(806) 212-2000
Mailing address
PO BOX 840026, DALLAS, TX 75284-0026
(806) 212-5079
(806) 212-6278
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
M4801
TX
208M00000X
Hospitalist Physician
Primary
M4801
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
198879212
—
TX
01
—
772765
MEDICARE
TX
Enumeration date
12/13/2006
Last updated
05/25/2021
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