Provider Demographics
NPI:1932309010
Name:KANTUTA, L.L.C.
Entity Type:Organization
Organization Name:KANTUTA, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR.
Authorized Official - Prefix:
Authorized Official - First Name:ALEJANDRO
Authorized Official - Middle Name:XAVIER
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:713-777-6677
Mailing Address - Street 1:14441 MEMORIAL DR
Mailing Address - Street 2:SUITE 25
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-6744
Mailing Address - Country:US
Mailing Address - Phone:713-777-6677
Mailing Address - Fax:713-621-9856
Practice Address - Street 1:14441 MEMORIAL DR
Practice Address - Street 2:SUITE 25
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-6744
Practice Address - Country:US
Practice Address - Phone:713-777-6677
Practice Address - Fax:713-621-9856
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-18
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8976111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty