Individual
MR. GUS CAVAZOS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5633 S STAPLES ST, 700, CORPUS CHRISTI, TX 78411-4646
(361) 814-2001
Mailing address
1317 WINDCREST ST, KINGSVILLE, TX 78363-6976
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
20939
TX
Other
Enumeration date
03/28/2014
Last updated
03/28/2014
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