Provider Demographics
NPI:1346333465
Name:CAVAZOS, GUADALUPE JAVEIR JR (DPM)
Entity Type:Individual
Prefix:MR
First Name:GUADALUPE
Middle Name:JAVEIR
Last Name:CAVAZOS
Suffix:JR
Gender:M
Credentials:DPM
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Mailing Address - Street 1:1401 E RIDGE RD
Mailing Address - Street 2:SUITE E
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503-1524
Mailing Address - Country:US
Mailing Address - Phone:956-618-2970
Mailing Address - Fax:956-618-2398
Practice Address - Street 1:1401 E RIDGE RD
Practice Address - Street 2:SUITE E
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1524
Practice Address - Country:US
Practice Address - Phone:956-618-2970
Practice Address - Fax:956-618-2398
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-09
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Provider Licenses
StateLicense IDTaxonomies
TX1263213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00845XMedicare ID - Type UnspecifiedGROUP
TXU55892Medicare UPIN
TX8D0035Medicare ID - Type UnspecifiedSINGLE