Individual
MIGUEL A CAVAZOS JR.
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1616 LOGAN, LAREDO, TX 78040
(956) 722-5162
(956) 722-0676
Mailing address
1616 LOGAN, LAREDO, TX 78040
(956) 722-5162
(956) 722-0676
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
D5267
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0087MN
BLUE CROSS BLUE SHIELD
TX
01
—
850770
BLUE CROSS BLUE SHIELD
TX
Enumeration date
04/04/2006
Last updated
07/09/2007
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