Provider Demographics
NPI:1558663310
Name:CANO, EDGAR NOEL (RD/LD)
Entity Type:Individual
Prefix:MR
First Name:EDGAR
Middle Name:NOEL
Last Name:CANO
Suffix:
Gender:M
Credentials:RD/LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:516 EDGEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78541-4229
Mailing Address - Country:US
Mailing Address - Phone:956-789-0811
Mailing Address - Fax:
Practice Address - Street 1:516 EDGEWOOD AVE
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78541-4229
Practice Address - Country:US
Practice Address - Phone:956-789-0811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-30
Last Update Date:2010-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT07710133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered