Provider Demographics
NPI:1760411144
Name:CANAVA, MARY ESTHER (NPC)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:ESTHER
Last Name:CANAVA
Suffix:
Gender:F
Credentials:NPC
Other - Prefix:
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Mailing Address - Street 1:902 CRYSTAL FALLS PKWY
Mailing Address - Street 2:
Mailing Address - City:LEANDER
Mailing Address - State:TX
Mailing Address - Zip Code:78641-3646
Mailing Address - Country:US
Mailing Address - Phone:512-259-2222
Mailing Address - Fax:512-259-2290
Practice Address - Street 1:1231 LEANDER RD
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78628-8707
Practice Address - Country:US
Practice Address - Phone:512-819-0790
Practice Address - Fax:512-819-0799
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2015-09-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX524937363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily