Organization
CANOVA INTERNAL MEDICINE CLINIC,PA.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDUARDO CARLOS CANOVA M.D. (PRESIDENT)
(956) 791-1414
Entity
Organization
Contact information
Practice address
6602 POLARIS DR., STE 5, LAREDO, TX 78041
(956) 791-1414
(956) 796-9495
Mailing address
6602 POLARIS DRIVE, STE 5, LAREDO, TX 78041
(956) 791-1414
(956) 796-9495
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
P0706
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
B0183294
DPS
TX
01
—
P0706
TX-LICENSE
TX
Enumeration date
09/16/2011
Last updated
03/07/2023
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