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NPI Code Detail

MEDICARE: DR. ROEL E CANTU M.D.

MEDICARE:  DR. ROEL E CANTU  M.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
1208000000XPediatrics PhysicianL4876TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1902804123
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROEL E CANTU M.D.
Provider Business Mailing Address
First Line : 411 W FM 495
Second Line :
City : SAN JUAN
State : TX
Zip : 78589-3717
Country : US
Telephone Number : 956-787-8100
Fax Number : 956-787-8117
Provider Business Practice Location Address
First Line : 411 W FM 495
Second Line :
City : SAN JUAN
State : TX
Zip : 78589-3717
Country : US
Telephone Number : 956-787-8100
Fax Number : 956-787-8117
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2005
Last Update Date : 07/29/2010

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Directions to “ DR. ROEL E CANTU M.D.” Practice Location

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