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General NPI Number Information
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NPI Number | 1275164378
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Entity Type | Individual
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Provider Name | ADRIAN PEREZ CANTU PT, DPT, MED
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Gender | Male
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Dates
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Enumeration Date | 01/28/2020
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Last Update Date | 01/28/2020
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Provider Practice Location Address
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Address Line | 3300 SW WILSHIRE BLVD
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City | JOSHUA
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State | TX
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Zip | 76058-6164
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Country | US
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Telephone | 682-207-8468
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Fax |
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Provider Business Mailing Address
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Address Line | 4952 STADIUM DR
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City | FORT WORTH
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State | TX
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Zip | 76133-1742
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Country | US
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Telephone | 361-549-9382
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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 | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 1307147
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License Number State | TX
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