Provider Demographics
NPI:1922242478
Name:CANLAS, GENNIE (MA)
Entity Type:Individual
Prefix:MS
First Name:GENNIE
Middle Name:
Last Name:CANLAS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7789 SOUTHWEST FWY
Mailing Address - Street 2:SUITE #470
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-1829
Mailing Address - Country:US
Mailing Address - Phone:281-649-7085
Mailing Address - Fax:713-995-4720
Practice Address - Street 1:7789 SOUTHWEST FWY
Practice Address - Street 2:SUITE #470
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-1829
Practice Address - Country:US
Practice Address - Phone:281-649-7085
Practice Address - Fax:713-995-4720
Is Sole Proprietor?:No
Enumeration Date:2009-04-28
Last Update Date:2009-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80061231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist