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Individual

CARLOS CAVAZOS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OTR

Contact information

Practice address
2001 S CYNTHIA ST STE A, MCALLEN, TX 78503-1278
(956) 630-6300
(956) 630-3443
Mailing address
2001 S CYNTHIA ST, STE A, MCALLEN, TX 78503-1278
(956) 630-6300
(956) 630-3443

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
113162
TX
225XP0200X
Pediatric Occupational Therapist
113162
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
167033301
TX
Enumeration date
07/30/2009
Last updated
10/20/2009
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