Healthcare Provider Details

I. General information

NPI: 1285604843
Provider Name (Legal Business Name): HECTOR MARIO CANTU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/25/2006
Last Update Date: 03/17/2025
Certification Date: 03/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6828 SPRINGFIELD AVE STE 1
LAREDO TX
78041-2287
US

IV. Provider business mailing address

6828 SPRINGFIELD AVE STE 1
LAREDO TX
78041-2287
US

V. Phone/Fax

Practice location:
  • Phone: 956-726-4060
  • Fax: 956-290-8720
Mailing address:
  • Phone: 956-726-4060
  • Fax: 956-290-8720

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberG6778
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: