Dr. Carolyn L Cannon, MD PhD
Pediatrics, Pediatric Pulmonology in Dallas, TX. Individual provider (NPI-1).
NPI number1740208552
StatusActive
Last updated in NPPESFeb 18, 2019
Details
- NPI
- 1740208552
- Entity type
- Individual (NPI-1)
- Name
- Dr. Carolyn L Cannon
- Credential
- MD PhD
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jul 18, 2006
- Last updated
- Feb 18, 2019
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - PEDIATRIC MEDICINE
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice Yes
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2080P0214X | Pediatrics, Pediatric Pulmonology | N4322 | TX | Yes |
| 2080P0201X | Pediatrics, Pediatric Allergy/Immunology | 2003014838 | MO |
Other names
- Carolyn Louise Preston (Former Name)
Practice location
5323 Harry Hines BlvdDallas, TX 75390-7201
Phone 214-456-2857 · Fax 214-456-5406
Mailing address
2900 E 29th StSte 100
Bryan, TX 77802-2623
Phone 979-436-0501 · Fax 979-776-6905
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