Individual
MS. INGRID MARION CAVANAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
PA-9102714
FL
363AM0700X
Medical Physician Assistant
Primary
PA05631
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200315403
—
TX
01
—
200315404
CSHCN
TX
Enumeration date
08/09/2007
Last updated
09/13/2017
Update your record
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