Provider Demographics
NPI:1285604843
Name:CANTU, HECTOR MARIO (MD)
Entity type:Individual
Prefix:
First Name:HECTOR
Middle Name:MARIO
Last Name:CANTU
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6828 SPRINGFIELD AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-2287
Mailing Address - Country:US
Mailing Address - Phone:956-726-4060
Mailing Address - Fax:956-290-8720
Practice Address - Street 1:6828 SPRINGFIELD AVE STE 1
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-2287
Practice Address - Country:US
Practice Address - Phone:956-726-4060
Practice Address - Fax:956-290-8720
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-25
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG6778208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX127029003Medicaid
TX00GL60OtherBLUE CROSS BLUE SHIELD