Provider Demographics
NPI:1194725366
Name:CANTU, DORA E (MD)
Entity type:Individual
Prefix:DR
First Name:DORA
Middle Name:E
Last Name:CANTU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:DORA
Other - Middle Name:E
Other - Last Name:FERNANDEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1740 W 27TH ST
Mailing Address - Street 2:SUITE 180
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008-1440
Mailing Address - Country:US
Mailing Address - Phone:713-864-8652
Mailing Address - Fax:713-864-2865
Practice Address - Street 1:1740 W 27TH ST
Practice Address - Street 2:SUITE 180
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-1440
Practice Address - Country:US
Practice Address - Phone:713-864-8652
Practice Address - Fax:713-864-2865
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH7593207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX123551701Medicaid
F57874Medicare UPIN
0926710001Medicare NSC
TX80K763Medicare PIN