Provider Demographics
NPI:1891771499
Name:CANTU, ROBERT E (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:E
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 1:1717 W 6TH ST
Mailing Address - Street 2:#440
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78703-4773
Mailing Address - Country:US
Mailing Address - Phone:512-469-0536
Mailing Address - Fax:
Practice Address - Street 1:1717 W 6TH ST
Practice Address - Street 2:#440
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78703-4773
Practice Address - Country:US
Practice Address - Phone:512-469-0536
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH42112084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXD80057Medicare UPIN