Provider Demographics
NPI:1285446955
Name:GAMEZ CANIZALEZ, KATIUSKA COROMOTO (CCHI)
Entity type:Individual
Prefix:MRS
First Name:KATIUSKA
Middle Name:COROMOTO
Last Name:GAMEZ CANIZALEZ
Suffix:
Gender:F
Credentials:CCHI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3623 HONEY DAISY DR
Mailing Address - Street 2:
Mailing Address - City:CRANDALL
Mailing Address - State:TX
Mailing Address - Zip Code:75114-0435
Mailing Address - Country:US
Mailing Address - Phone:214-554-3099
Mailing Address - Fax:
Practice Address - Street 1:3623 HONEY DAISY DR
Practice Address - Street 2:
Practice Address - City:CRANDALL
Practice Address - State:TX
Practice Address - Zip Code:75114-0435
Practice Address - Country:US
Practice Address - Phone:214-554-3099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-21
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX013632171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter