Provider Demographics
NPI:1407415086
Name:CANLAS, JESSICA EIREEN (DO)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:EIREEN
Last Name:CANLAS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:5340 WALZEM RD STE 5340
Mailing Address - Street 2:
Mailing Address - City:WINDCREST
Mailing Address - State:TX
Mailing Address - Zip Code:78218-2123
Mailing Address - Country:US
Mailing Address - Phone:210-653-8085
Mailing Address - Fax:210-599-8508
Practice Address - Street 1:5340 WALZEM RD STE 5340
Practice Address - Street 2:
Practice Address - City:WINDCREST
Practice Address - State:TX
Practice Address - Zip Code:78218-2123
Practice Address - Country:US
Practice Address - Phone:210-653-8085
Practice Address - Fax:210-599-8508
Is Sole Proprietor?:No
Enumeration Date:2019-06-07
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXT5839207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine