MEDICARE: DR. ROBERT E CANTU MD

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
1	2084P0800X	Psychiatry Physician	H4211	TX

General Provider Information

NPI Number	:	1891771499
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT E CANTU MD

Provider Business Mailing Address
First Line	:	1717 W 6TH ST
Second Line	:	#440
City	:	AUSTIN
State	:	TX
Zip	:	78703-4773
Country	:	US
Telephone Number	:	512-469-0536
Fax Number	:

Provider Business Practice Location Address
First Line	:	1717 W 6TH ST
Second Line	:	#440
City	:	AUSTIN
State	:	TX
Zip	:	78703-4773
Country	:	US
Telephone Number	:	512-469-0536
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/16/2005
Last Update Date	:	07/08/2007

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