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General NPI Number Information
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NPI Number | 1629435110
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Entity Type | Organization
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Legal Business Name | CANTERA PSYCHIATRY, PLLC
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Dates
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Enumeration Date | 01/28/2016
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Last Update Date | 09/27/2023
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Provider Practice Location Address
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Address Line | 85 NE LOOP 410 STE 420
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City | SAN ANTONIO
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State | TX
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Zip | 78216-5836
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Country | US
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Telephone | 210-960-4352
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Fax | 833-471-4781
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Provider Business Mailing Address
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Address Line | 85 NE LOOP 410 STE 420
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City | SAN ANTONIO
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State | TX
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Zip | 78216-5836
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Country | US
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Telephone | 210-960-4352
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Fax | 833-471-4781
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | ABIGAIL HERNANDEZ
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Credential |
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Telephone | 210-960-4352
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | Q2556
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License Number State | TX
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