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NPI Code Detail

MEDICARE: VICTOR CANTU RN

MEDICARE:   VICTOR  CANTU  RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse824155TX

General Provider Information

NPI Number : 1376022665
Entity Type Code : Individual
Provider Name (Legal Business Name) : VICTOR CANTU RN
Provider Business Mailing Address
First Line : 8700 CROWNHILL BLVD STE 300
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78209-1128
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8700 CROWNHILL BLVD STE 300
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78209-1128
Country : US
Telephone Number : 210-824-5530
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2018
Last Update Date : 08/08/2018

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