Individual
ELIAS T KANAAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
210 W PARK STE 104, LIVINGSTON, TX 77351-8337
(936) 328-5820
(936) 328-5824
Mailing address
210 W PARK STE 104, LIVINGSTON, TX 77351-8337
(936) 328-5820
(936) 328-5824
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
K3270
TX
207RN0300X
Nephrology Physician
K3270
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0002MT
BCBS INDIVIDUAL
TX
05
—
047563402
—
TX
01
—
P00234310
MEDICARE RAILROAD PIN
TX
Enumeration date
06/23/2005
Last updated
12/06/2021
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