Provider Demographics
NPI:1144498205
Name:PATRICIA ANN CANTU MD PA
Entity type:Organization
Organization Name:PATRICIA ANN CANTU MD PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:CANTU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:361-986-9300
Mailing Address - Street 1:7101 S STAPLES ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78413-5542
Mailing Address - Country:US
Mailing Address - Phone:361-986-9300
Mailing Address - Fax:361-986-9301
Practice Address - Street 1:7101 S. STAPLE ST
Practice Address - Street 2:SUITE #105
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78413
Practice Address - Country:US
Practice Address - Phone:361-986-9300
Practice Address - Fax:361-986-9301
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OSO URGENT CARE & FAMILY MEDICINE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-02-12
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK9240305R00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No305R00000XManaged Care OrganizationsPreferred Provider OrganizationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH72803OtherUPIN
TXH72803OtherUPIN