Provider Demographics
NPI:1174056618
Name:CANTU, ROLANDO JR (DO)
Entity type:Individual
Prefix:
First Name:ROLANDO
Middle Name:
Last Name:CANTU
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:612 E BAILEY BOSWELL RD STE 200
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:TX
Mailing Address - Zip Code:76131-3571
Mailing Address - Country:US
Mailing Address - Phone:817-232-1343
Mailing Address - Fax:
Practice Address - Street 1:612 E BAILEY BOSWELL RD STE 200
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:TX
Practice Address - Zip Code:76131-3571
Practice Address - Country:US
Practice Address - Phone:817-232-1343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-11
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS7619207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine