Active NPI
Roberto Omar Cantu, DC
- Chiropractor
- League City, TX
National Provider Identifier
1649276213
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 9787
- Practice address
- 3027 Marina Bay Dr
League City, TX 77573-2729 - Phone
- (832) 864-3769
- Fax
- (858) 509-3993
- NPI assigned
- Jun 28, 2005
- Last updated
- Jul 21, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 9787 | TX | Primary |
Addresses
Primary practice location
3027 Marina Bay Dr
League City, TX 77573-2729
Mailing address
3027 Marina Bay Dr
203
League City, TX 77573-2888
Phone (832) 864-3769
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8P1440 | Other | TX | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050224000418 | TX | Practitioner - Chiropractic | 0042263774 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Palmer Highway Chiropractic | Chiropractor | Current | Accepting new patients |
| Cantu Chiropractic | Chiropractor | Current | Accepting new patients |
Locations
2709 Palmer Hwy
Texas City, TX 77590
Phone (409) 948-1000
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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- Chiropractor
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- NPI 1578929527
-
- Chiropractor
- Texas City, TX
- NPI 1750392387
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119916800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1649276213",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3027 MARINA BAY DR",
"address_2": "203",
"city": "LEAGUE CITY",
"state": "TX",
"postal_code": "775732888",
"telephone_number": "832-864-3769",
"fax_number": "858-509-3993"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3027 MARINA BAY DR",
"city": "LEAGUE CITY",
"state": "TX",
"postal_code": "775732729",
"telephone_number": "832-864-3769",
"fax_number": "858-509-3993"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CANTU",
"first_name": "ROBERTO",
"middle_name": "OMAR",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-06-28",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "TX",
"license": "9787",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "8P1440",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in League City, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.