Provider Demographics
NPI:1548377088
Name:CANALES, JOHN FIERROS (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:FIERROS
Last Name:CANALES
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Gender:M
Credentials:MD
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Mailing Address - Street 1:4411 MEDICAL DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3822
Mailing Address - Country:US
Mailing Address - Phone:210-614-5400
Mailing Address - Fax:210-614-2413
Practice Address - Street 1:12709 TOEPPERWEIN RD
Practice Address - Street 2:SUITE 306
Practice Address - City:LIVE OAK
Practice Address - State:TX
Practice Address - Zip Code:78233-3258
Practice Address - Country:US
Practice Address - Phone:210-967-0096
Practice Address - Fax:210-967-0383
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2022-07-21
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Provider Licenses
StateLicense IDTaxonomies
TXM3955207RI0011X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8DV569OtherBCBSTX
TX190711505Medicaid
TX308588YR99OtherMEDICARE
TXP01237072OtherRAILROAD MEDICARE
TX190711505Medicaid
TX8DV569OtherBCBSTX