Cannon, Michael
Cannon, Michael is an sole proprietor health care provider with primary practice located at 402 E Zavala St , Crystal City TX 78839-3337. He recently has 2 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Podiatrist, Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery. Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery is his primary health care specialty. Cannon, Michael can be contacted via phone (720) 252-7546.Contact Information
Primary practice address
402 E Zavala St
Crystal City TX 78839-3337
Phone: (720) 252-7546
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Podiatric Medicine & Surgery Service Providers / Podiatrist | 213E00000X | 2169 | Texas |
| Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery | 213ES0103X | 2169 | Texas |
Profile Details
| NPI number | 1922494673 |
|---|---|
| LBN Legal business name | Cannon, Michael |
| Credentials | Doctor of Podiatric Medicine (DPM) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 9th, 2015 |
| Last updated | Apr 11th, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1922494673 | NPPES |
| Texas | MEDICAID | 3520348-01 |
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