Provider Demographics
NPI:1881650547
Name:CANO-HOWES, MELINDA ANITA (OD)
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:ANITA
Last Name:CANO-HOWES
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8801 HORIZON BLVD NE
Mailing Address - Street 2:SUITE 360
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87113-1533
Mailing Address - Country:US
Mailing Address - Phone:505-828-4923
Mailing Address - Fax:505-213-0103
Practice Address - Street 1:1603 MAIN STREET, SW
Practice Address - Street 2:SUITE B
Practice Address - City:LOS LUNAS
Practice Address - State:NM
Practice Address - Zip Code:87031
Practice Address - Country:US
Practice Address - Phone:505-865-6100
Practice Address - Fax:505-213-0103
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2013-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM514152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM53082877Medicaid
NMP00479952OtherMEDICARE ID (RAILROAD MEDICARE)
AZ264206Medicaid
NMNM00PB82OtherBC BS OF NM
U82446Medicare UPIN
NM346728806Medicare PIN