MEDICARE: MS. ADRIANA FARID CANTU R.D., L.D.

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
1	133V00000X	Registered Dietitian	DT82032	TX

General Provider Information

NPI Number	:	1396160750
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ADRIANA FARID CANTU R.D., L.D.

Provider Business Mailing Address
First Line	:	4200 LAS PALMAS CIR APT 728
Second Line	:
City	:	BROWNSVILLE
State	:	TX
Zip	:	78521-2884
Country	:	US
Telephone Number	:	956-648-5569
Fax Number	:

Provider Business Practice Location Address
First Line	:	4200 LAS PALMAS CIR APT 728
Second Line	:
City	:	BROWNSVILLE
State	:	TX
Zip	:	78521-2884
Country	:	US
Telephone Number	:	956-648-5569
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/21/2014
Last Update Date	:	02/21/2014

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