Provider Demographics
NPI:1922472281
Name:CANO, CARMEN NATALIA
Entity Type:Individual
Prefix:
First Name:CARMEN
Middle Name:NATALIA
Last Name:CANO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CONCEPCION
Other - Middle Name:
Other - Last Name:FLORES PUGA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:922 MARLOW RD
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79905-3202
Mailing Address - Country:US
Mailing Address - Phone:915-328-4144
Mailing Address - Fax:
Practice Address - Street 1:922 MARLOW RD
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79905-3202
Practice Address - Country:US
Practice Address - Phone:915-328-4144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-23
Last Update Date:2015-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9.12.070N171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor