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Organization
S-S-C
Active
Organization
S-S-C
Active
Parent organization
S-S-C
Other names
BRUSH COUNTRY MEDICAL PLLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
S-S-C
Authorized official
DR. SERGIO SAUL CANTU MD (PRESIDENT)
(210) 379-7480
Entity
Organization
Contact information
Practice address
779 N TEXAS BLVD, ALICE, TX 78332-3883
(361) 668-0919
(361) 668-0816
Mailing address
779 N TEXAS BLVD, ALICE, TX 78332-3883
(361) 668-0919
(361) 668-0816
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
P0707
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300671001
—
TX
Enumeration date
01/18/2012
Last updated
12/12/2023
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