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NPI Code Detail

MEDICARE: ALEJANDRO ALFONSO CANTU OTR

MEDICARE: ALEJANDRO ALFONSO CANTU OTR
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist108458TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1108458OTHERTXLICENSE NUMBER
281517TOTHERTXBCBS NUMBER

General Provider Information

NPI Number : 1083810824
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEJANDRO ALFONSO CANTU OTR
Provider Business Mailing Address
First Line : 1220 N MALINCHE AVE
Second Line :
City : LAREDO
State : TX
Zip : 78043-3354
Country : US
Telephone Number : 956-722-2431
Fax Number : 956-722-7553
Provider Business Practice Location Address
First Line : 1220 N MALINCHE AVE
Second Line :
City : LAREDO
State : TX
Zip : 78043-3354
Country : US
Telephone Number : 956-722-2431
Fax Number : 956-722-7553
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/26/2007
Last Update Date : 05/24/2021

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Directions to “ ALEJANDRO ALFONSO CANTU OTR” Practice Location

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