Cannon, Carolyn L

Cannon, Carolyn L is an individual health care provider with primary practice located at 5323 Harry Hines Blvd , Dallas TX 75390-7201. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatric Allergy/Immunology, Allopathic & Osteopathic Physicians / Pediatric Pulmonology. Allopathic & Osteopathic Physicians / Pediatric Pulmonology is her primary health care specialty. Cannon, Carolyn L can be contacted via phone (214) 456-2857.

Contact Information

Primary practice address
5323 Harry Hines Blvd Dallas TX 75390-7201
Phone: (214) 456-2857
Fax: (214) 456-5406
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Allergy/Immunology 2080P0201X 2003014838 Missouri
Allopathic & Osteopathic Physicians / Pediatric Pulmonology 2080P0214X N4322 Texas

Profile Details

NPI number 1740208552
LBN Legal business name Cannon, Carolyn L
Credentials MD PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 18th, 2006
Last updated Feb 18th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1740208552 NPPES
Missouri MEDICAID 209230002

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