Provider Demographics
NPI:1417095787
Name:CANTU, DANIEL D (DC)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:D
Last Name:CANTU
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1419 LYNNVIEW DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77055-3425
Mailing Address - Country:US
Mailing Address - Phone:713-468-2328
Mailing Address - Fax:
Practice Address - Street 1:6227 SOUTHWEST FWY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-2201
Practice Address - Country:US
Practice Address - Phone:713-777-7775
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6930111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX605739Medicare ID - Type UnspecifiedCHIROPRACTIC