Basic Information
| Provider Information | |||||||||
| NPI: | 1003101916 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CAVAZOS | ||||||||
| FirstName: | ELVIS | ||||||||
| MiddleName: | AARON | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 841969 | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752841969 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3288242999 | ||||||||
| FaxNumber: | 8328258901 | ||||||||
| Practice Location | |||||||||
| Address1: | 14730 BARRYKNOLL LN | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770792802 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2814969700 | ||||||||
| FaxNumber: | 2814967821 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/20/2011 | ||||||||
| LastUpdateDate: | 10/22/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | P9534 | TX | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.