Provider Demographics
NPI:1023086345
Name:CANALES, RICARDO (MD PA)
Entity type:Individual
Prefix:
First Name:RICARDO
Middle Name:
Last Name:CANALES
Suffix:
Gender:M
Credentials:MD PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 LINDBERG AVE
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-2920
Mailing Address - Country:US
Mailing Address - Phone:956-627-0531
Mailing Address - Fax:956-627-0248
Practice Address - Street 1:240 LINDBERG AVE
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-2920
Practice Address - Country:US
Practice Address - Phone:956-627-0531
Practice Address - Fax:956-627-0248
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-11
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK4385207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX092233802OtherTX HEALTH STEPS
TX092233801Medicaid
G79995Medicare UPIN
TX092233801Medicaid