Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | P9534 | TX |
NPI | 1003101916 |
---|---|
Provider Name | Elvis Aaron Cavazos |
First Address | Dallas, TX 75284-1969 |
Second Address | Houston, TX 77079-2802 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2011 |
Last Update Date | 22/10/2019 |