Provider Demographics
NPI:1881796423
Name:CANTU, MELINDA ELIZABETH (PT)
Entity type:Individual
Prefix:
First Name:MELINDA
Middle Name:ELIZABETH
Last Name:CANTU
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:MELINDA
Other - Middle Name:ELIZABETH
Other - Last Name:HUGHS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:809 WOODBRIDGE PKWY # 500-414
Mailing Address - Street 2:
Mailing Address - City:WYLIE
Mailing Address - State:TX
Mailing Address - Zip Code:75098-7148
Mailing Address - Country:US
Mailing Address - Phone:214-734-2046
Mailing Address - Fax:972-429-1145
Practice Address - Street 1:2011 N COLLINS BLVD # 601
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-2636
Practice Address - Country:US
Practice Address - Phone:214-734-2046
Practice Address - Fax:972-429-1145
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-03
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1152869225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1152869OtherPT LICENSE #
TX470985ZS1MMedicare PIN