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Individual

YOLANDA RUTH CANTU

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LSA

Contact information

Practice address
540 MADISON OAK DR, STE 610, SAN ANTONIO, TX 78258-3943
(210) 352-5346
(210) 352-5367
Mailing address
540 MADISON OAK DR, STE 610, SAN ANTONIO, TX 78258-3924
(210) 352-5346
(210) 352-5367

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
SA00533
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
12678894
CAQH
TX
01
84NN65
BCBS
TX
01
SA00533
TEXAS MEDICAL BOARD
TX
Enumeration date
08/08/2013
Last updated
02/01/2018
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