Provider Demographics
NPI:1003068917
Name:CAVAZOS, HOMERO OSVALDO (DC)
Entity Type:Individual
Prefix:DR
First Name:HOMERO
Middle Name:OSVALDO
Last Name:CAVAZOS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 ABERDEEN AVE
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-7294
Mailing Address - Country:US
Mailing Address - Phone:214-914-5684
Mailing Address - Fax:214-377-4836
Practice Address - Street 1:4508 LEGACY DR
Practice Address - Street 2:SUITE 200
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-2183
Practice Address - Country:US
Practice Address - Phone:214-377-4833
Practice Address - Fax:214-377-4836
Is Sole Proprietor?:No
Enumeration Date:2008-10-22
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11011111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology