Provider Demographics
NPI:1194138214
Name:CANCIO, ANTHONY TRAVIS (MD)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:TRAVIS
Last Name:CANCIO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1805 TIN STAR ST
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79911-3108
Mailing Address - Country:US
Mailing Address - Phone:213-840-8280
Mailing Address - Fax:
Practice Address - Street 1:18511 HIGHLANDER MEDICS ST
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79906-5327
Practice Address - Country:US
Practice Address - Phone:915-472-0278
Practice Address - Fax:915-569-0722
Is Sole Proprietor?:No
Enumeration Date:2014-06-05
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-18552207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAD000Medicare UPIN