Provider Demographics
NPI:1548267180
Name:CANO-GONZALEZ, CHRISTINA (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:
Last Name:CANO-GONZALEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:351 N SAM HOUSTON BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN BENITO
Mailing Address - State:TX
Mailing Address - Zip Code:78586-4656
Mailing Address - Country:US
Mailing Address - Phone:956-399-2443
Mailing Address - Fax:956-399-6331
Practice Address - Street 1:351 N SAM HOUSTON BLVD
Practice Address - Street 2:
Practice Address - City:SAN BENITO
Practice Address - State:TX
Practice Address - Zip Code:78586-4656
Practice Address - Country:US
Practice Address - Phone:956-399-2443
Practice Address - Fax:956-399-6331
Is Sole Proprietor?:No
Enumeration Date:2005-06-28
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL6815207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX160380501Medicaid
TX160380501Medicaid
8B1047Medicare PIN