Provider Demographics
NPI:1760441430
Name:CANAVAN, LYNN DIDONATO (MD)
Entity Type:Individual
Prefix:DR
First Name:LYNN
Middle Name:DIDONATO
Last Name:CANAVAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:972-437-9605
Practice Address - Street 1:4708 ALLIANCE BLVD STE 750
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5354
Practice Address - Country:US
Practice Address - Phone:972-562-5999
Practice Address - Fax:972-562-9755
Is Sole Proprietor?:No
Enumeration Date:2006-03-21
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ2864208600000X, 2086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX127583606Medicaid
TX8W4998OtherBCBSTX
TXP00620587OtherMEDICARE RAILROAD
TX8W4998OtherBCBSTX
TX0063BXMedicare PIN
TX8W4998OtherBCBSTX
TXF65495Medicare UPIN