Individual
MARK RICHARD CAVANAUGH
Active
Individual
MARK RICHARD CAVANAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
N9825
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
284379901
—
TX
05
—
284379902
—
TX
05
—
284397701
—
TX
01
—
8CX604
BLUE CROSS BLUE SHIELD
TX
01
—
P01192066
RR MEDICARE
TX
Enumeration date
07/12/2007
Last updated
05/04/2022
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