Provider Demographics
NPI:1912941873
Name:CANTU, DENNIS DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:DAVID
Last Name:CANTU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1710 E SAUNDERS ST
Mailing Address - Street 2:SUITE B-650
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-5443
Mailing Address - Country:US
Mailing Address - Phone:956-727-7766
Mailing Address - Fax:956-796-1186
Practice Address - Street 1:1710 E SAUNDERS ST
Practice Address - Street 2:SUITE B-650
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-5443
Practice Address - Country:US
Practice Address - Phone:956-727-7766
Practice Address - Fax:956-796-1186
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-15
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXF1430207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXC14161Medicare UPIN
TX00CX13Medicare PIN