Provider Demographics
NPI:1770788622
Name:CANTU-GARZA, MELISSA S (PA)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:S
Last Name:CANTU-GARZA
Suffix:
Gender:F
Credentials:PA
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 6139
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78502-6139
Mailing Address - Country:US
Mailing Address - Phone:956-973-2446
Mailing Address - Fax:956-973-2686
Practice Address - Street 1:902 S AIRPORT DR
Practice Address - Street 2:SUITE 6
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596-6644
Practice Address - Country:US
Practice Address - Phone:956-973-2446
Practice Address - Fax:956-973-2686
Is Sole Proprietor?:No
Enumeration Date:2007-06-20
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA05305363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX291258602Medicaid
TX291258602Medicaid
TX289080YNG9Medicare PIN