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General NPI Number Information
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NPI Number | 1780977512
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Entity Type | Individual
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Provider Name | JAMES RAE CANTU M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/26/2011
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Last Update Date | 04/25/2025
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Provider Practice Location Address
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Address Line | 12 HIGH ST STE 302
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City | LEWISTON
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State | ME
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Zip | 04240-7690
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Country | US
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Telephone | 207-795-8385
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Fax |
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Provider Business Mailing Address
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Address Line | 7260 FM 1303
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City | FLORESVILLE
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State | TX
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Zip | 78114-6458
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Country | US
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Telephone | 979-739-3294
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Fax | 254-215-9722
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD61661052
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | N9683
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License Number State | TX
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