Provider Information for 1962894857
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CARLOS CAVAZOS LPC
Sex: Male
NPI: 1962894857
Last Updated: 2015-03-02
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1962894857 | ||||||||
| Enumeration Date | 2015-03-02 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 3031 W IH 10 SAN ANTONIO, TX 78201-5159 United States Phone: 210-261-1000 | Fax:210-731-8678 | ||||||||
| Primary Practice Address | 3031 W IH 10 SAN ANTONIO, TX 78201-5159 United States Phone: 210-261-1000 | Fax:210-731-8678 | ||||||||
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