Samuel Canon, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

3765T Issued in TX

Practice address

155 SE Loop 338
Odessa, TX 79762-9708

Phone

(432) 367-7241

Fax

(432) 550-3427

NPI assigned

Mar 17, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Alan D Smith MD PA

  • Ophthalmology Physician
  • Odessa, TX
  • NPI 1497701056
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254355200000",
    "number": "1285693473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 BOYD AVE",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797058502",
            "telephone_number": "432-367-7241",
            "fax_number": "432-550-3427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 SE LOOP 338",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797629708",
            "telephone_number": "432-367-7241",
            "fax_number": "432-550-3427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANON",
        "first_name": "SAMUEL",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-17",
        "last_updated": "2009-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "3765T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "129284906",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gina Marie Campagna, M.D.
• Curtis Sean Campbell, OTA
• Emily Campbell, B.S. ATC, LAT
• Madison Mackenzie Campbell, OT
• Neri Campos-Gardea
• Caprock Home Health Services, Inc.
• Caprock Home Health Services, Inc.
• Cardiac Surgical Associates of West Texas
• Cardiovascular Specialists of Texas, P.a
• Cardiovascular Specialists of Texas, P.a.

• Optometrist in Odessa, TX
• Providers in Odessa, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.