Provider Demographics
NPI:1255600920
Name:KANTARA, HAMID C (DC)
Entity type:Individual
Prefix:DR
First Name:HAMID
Middle Name:C
Last Name:KANTARA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1101 W MAIN ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-2046
Mailing Address - Country:US
Mailing Address - Phone:281-557-3339
Mailing Address - Fax:832-932-5223
Practice Address - Street 1:1101 W MAIN ST
Practice Address - Street 2:SUITE C
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-2046
Practice Address - Country:US
Practice Address - Phone:281-557-3339
Practice Address - Fax:832-932-5223
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-23
Last Update Date:2017-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7404111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor