Provider Demographics
NPI:1487093308
Name:CANO, BENITO
Entity type:Individual
Prefix:
First Name:BENITO
Middle Name:
Last Name:CANO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:BENITO
Other - Middle Name:NATHANAEL
Other - Last Name:CANO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP
Mailing Address - Street 1:2605 RUIZ ST
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78521-3843
Mailing Address - Country:US
Mailing Address - Phone:956-466-3754
Mailing Address - Fax:
Practice Address - Street 1:1755 W PRICE RD
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520-4235
Practice Address - Country:US
Practice Address - Phone:569-546-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-25
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX742167363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily