Provider Demographics
NPI:1861651598
Name:CANO, MARTHA G (MD)
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:G
Last Name:CANO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 3046
Mailing Address - Street 2:
Mailing Address - City:MALVERN
Mailing Address - State:PA
Mailing Address - Zip Code:19355-0746
Mailing Address - Country:US
Mailing Address - Phone:956-969-5995
Mailing Address - Fax:956-969-1680
Practice Address - Street 1:2017 W EXPRESSWAY 83 STE 1&2
Practice Address - Street 2:
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596-4325
Practice Address - Country:US
Practice Address - Phone:956-969-5995
Practice Address - Fax:956-969-1680
Is Sole Proprietor?:No
Enumeration Date:2008-06-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXN0071207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX206566601Medicaid
TX8CC588OtherBCBS TX
TX8CC588OtherBCBS TX