Provider Demographics
NPI:1134722259
Name:CANALES, WALDINA L (PHARMACIST)
Entity type:Individual
Prefix:
First Name:WALDINA
Middle Name:L
Last Name:CANALES
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7395 PADRE ISLAND HWY
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78521-3467
Mailing Address - Country:US
Mailing Address - Phone:956-838-1264
Mailing Address - Fax:956-838-1348
Practice Address - Street 1:7395 PADRE ISLAND HWY
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78521-3467
Practice Address - Country:US
Practice Address - Phone:956-838-1264
Practice Address - Fax:956-838-1348
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-19
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX52156183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist