Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RX0202X | Medical Oncology | D1192 | TX |
NPI | 1053427674 |
---|---|
Provider Name | Lawrence C Canning |
First Address | Waco, TX 76708-3245 |
Second Address | Waco, TX 76708-3245 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
97713402 | (05) | TX |