Provider Demographics
NPI:1720891559
Name:CANTU, LETICIA Y
Entity type:Individual
Prefix:
First Name:LETICIA
Middle Name:Y
Last Name:CANTU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LETTY
Other - Middle Name:Y
Other - Last Name:CANTU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:9000 SOUTHWEST FWY STE 260
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-1520
Mailing Address - Country:US
Mailing Address - Phone:713-367-2790
Mailing Address - Fax:866-598-4096
Practice Address - Street 1:9000 SOUTHWEST FWY STE 260
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-1520
Practice Address - Country:US
Practice Address - Phone:713-995-8818
Practice Address - Fax:713-995-0505
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-27
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology