Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 41990 | AZ |
Y | 2080N0001X | Neonatal-Perinatal Doctor | N7064 | TX |
N | 2080P0208X | Pediatric Infectious Diseases | N7064 | TX |
NPI | 1023167582 |
---|---|
Provider Name | Dr. Joseph Benjamin Cantey IV |
First Address | San Antonio, TX 78229-3901 |
Second Address | San Antonio, TX 78229-4402 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/01/2007 |
Last Update Date | 03/07/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
323281105 | (05) | TX |
323281106 | CSHCN (01) | TX |
421086 | (05) | AZ |