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General NPI Number Information
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NPI Number | 1023623683
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Entity Type | Individual
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Provider Name | CAROLINA CANTU PHARMD
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Gender | Female
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Dates
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Enumeration Date | 09/10/2020
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Last Update Date | 08/17/2021
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Provider Practice Location Address
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Address Line | 2700 W FREDDY GONZALEZ DR
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City | EDINBURG
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State | TX
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Zip | 78539-7312
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Country | US
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Telephone | 956-383-4083
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Fax |
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Provider Business Mailing Address
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Address Line | 904 STANFORD CT
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City | EDINBURG
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State | TX
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Zip | 78541-9841
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Country | US
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Telephone | 956-573-4911
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | 237052
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 36691
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 69109
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License Number State | TX
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