Provider Demographics
NPI:1659340982
Name:CANTU, RODRIGO DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:RODRIGO
Middle Name:DAVID
Last Name:CANTU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2961 MOSSROCK
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-5119
Mailing Address - Country:US
Mailing Address - Phone:210-731-4800
Mailing Address - Fax:210-731-4810
Practice Address - Street 1:810 SE MILITARY DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78214-2823
Practice Address - Country:US
Practice Address - Phone:210-921-4200
Practice Address - Fax:210-922-8181
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2020-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK7682207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXK7682OtherTX LICENSE NUMBER
TXK7682OtherTX LICENSE NUMBER
TXK7682OtherTX LICENSE NUMBER
TX8EV215OtherBCBSTX
TX144031507Medicaid