Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | BP10052476 | TX |
N | 111NI0900X | Internist | BP10052476 | TX |
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | S6368 | TX |
NPI | 1093102923 |
---|---|
Provider Name | Amanda Noemi Cantu |
First Address | Mcallen, TX 78503-1589 |
Second Address | Mcallen, TX 78503-1589 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2015 |
Last Update Date | 24/12/2020 |