Provider Demographics
NPI:1669078184
Name:CANO, MARIA
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:CANO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:DELCARMEN
Other - Last Name:CANO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:101 FEU FOLLET RD STE 100
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-4234
Mailing Address - Country:US
Mailing Address - Phone:713-686-9194
Mailing Address - Fax:713-686-9413
Practice Address - Street 1:8000 WEST AVE STE 1
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78213-1837
Practice Address - Country:US
Practice Address - Phone:713-686-9194
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-09
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX81225101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX419016701Medicaid