Provider Demographics
NPI:1942234588
Name:GARCIA CANTU, CARLOS (MD)
Entity Type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:
Last Name:GARCIA 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:PO BOX 2975
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78502-2975
Mailing Address - Country:US
Mailing Address - Phone:956-362-8170
Mailing Address - Fax:956-362-8168
Practice Address - Street 1:1100 E DOVE AVE STE 300
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-4672
Practice Address - Country:US
Practice Address - Phone:956-362-8170
Practice Address - Fax:956-362-8168
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK0763208600000X, 2086S0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX031450204Medicaid
TXP01021402OtherRAILROAD
TX031450203Medicaid
TXK0763OtherTEXAS STATE BOARD OF MEDI
TXP00410275OtherRAILROAD
TX0029PAOtherBCBS
TX031450205Medicaid
TX031450208Medicaid
TX020047844OtherRAILROAD
TX031450201Medicaid
TX031450207Medicaid
TXG27605Medicare UPIN
TXG27605Medicare ID - Type UnspecifiedMEDICARE NUMBER
TXK0763OtherTEXAS STATE BOARD OF MEDI
TX8D4129Medicare ID - Type UnspecifiedSTV MEDICARE NUMBER
TX031450207Medicaid
TXP00410275OtherRAILROAD
TXP01021402OtherRAILROAD
TX031450203Medicaid