Canon, Samuel
Canon, Samuel is an individual health care provider with primary practice located at 155 Se Loop 338 , Odessa TX 79762-9708. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Canon, Samuel can be contacted via phone (432) 367-7241.Contact Information
Primary practice address
155 Se Loop 338
Odessa TX 79762-9708
Phone: (432) 367-7241
Fax: (432) 550-3427
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 3765T | Texas |
Profile Details
| NPI number | 1285693473 |
|---|---|
| LBN Legal business name | Canon, Samuel |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 17th, 2006 |
| Last updated | Oct 1st, 2009 - about 15 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1285693473 | NPPES |
| Texas | MEDICAID | 129284906 |
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