Basic Information
| Provider Information | |||||||||
| NPI: | 1326308263 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CANTU | ||||||||
| FirstName: | CONRADO | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4455 SPID DR | ||||||||
| Address2: | SUITE 116 | ||||||||
| City: | CORPUS CHRISTI | ||||||||
| State: | TX | ||||||||
| PostalCode: | 784115101 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3619931083 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2601 HOSPITAL BLVD | ||||||||
| Address2: | SUITE 117 | ||||||||
| City: | CORPUS CHRISTI | ||||||||
| State: | TX | ||||||||
| PostalCode: | 784051815 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3619024789 | ||||||||
| FaxNumber: | 3619024588 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/25/2012 | ||||||||
| LastUpdateDate: | 08/27/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | Q5361 | TX | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.