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Provider Information for 1134122120

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

DR. SHELLEY LYNN CANADA D.D.S.

Gender: FEMALE

Individual NPI: 1134122120

Calendar   Last Updated:  2012-09-27
  Certification Date: 

Details

Name Value
NPI 1134122120
Enumeration Date 2005-05-23
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 8556 KATY FWY STE 100
HOUSTON, TX 77024-1806
United States

Phone: 713-957-8668 | Fax: 713-957-3441
View Map External Link
Primary Practice Address 8556 KATY FWY STE 100
HOUSTON, TX 77024-1806
United States

Phone: 713-957-8668 | Fax: 713-957-3441
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 1223G0001X - Dentist General Practice TX 16412