Individual
MARK RICHARD CAVANAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6606 LBJ FWY STE 200, DALLAS, TX 75240-6524
(972) 715-5000
(972) 715-9976
Mailing address
PO BOX 840853, DALLAS, TX 75284-0853
(972) 233-1999
(972) 233-3666
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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