Provider Demographics
NPI:1306529755
Name:CANTU, HESIQUIO IV (PTA)
Entity type:Individual
Prefix:MR
First Name:HESIQUIO
Middle Name:
Last Name:CANTU
Suffix:IV
Gender:M
Credentials:PTA
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5026 DEEPWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78415-2901
Mailing Address - Country:US
Mailing Address - Phone:361-854-2278
Mailing Address - Fax:361-854-2389
Practice Address - Street 1:4040 FIVE POINTS RD
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78410-4538
Practice Address - Country:US
Practice Address - Phone:361-241-7399
Practice Address - Fax:361-241-7464
Is Sole Proprietor?:No
Enumeration Date:2023-08-11
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant