Provider Demographics
NPI:1629250774
Name:CANTU, JAMES STEWART (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:STEWART
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:PO BOX 7101
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77903-7101
Mailing Address - Country:US
Mailing Address - Phone:361-485-1225
Mailing Address - Fax:361-485-1226
Practice Address - Street 1:1717 N LAURENT ST
Practice Address - Street 2:SUITE 100
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77901-6236
Practice Address - Country:US
Practice Address - Phone:361-485-1225
Practice Address - Fax:361-485-1226
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-30
Last Update Date:2014-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9502111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor