Provider Demographics
NPI:1073556262
Name:CANTU, HECTOR (DO)
Entity Type:Individual
Prefix:
First Name:HECTOR
Middle Name:
Last Name:CANTU
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 200993
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77216-0993
Mailing Address - Country:US
Mailing Address - Phone:281-784-1111
Mailing Address - Fax:281-784-1555
Practice Address - Street 1:6002 FAIRMONT PKWY
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77505-4037
Practice Address - Country:US
Practice Address - Phone:713-359-2100
Practice Address - Fax:713-359-2100
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARB3952207Q00000X
TXG8035207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8S9238OtherBCBSTX
TX131710909Medicaid
TX131710907Medicaid
TX8J2311Medicare PIN
TX8J2310Medicare PIN