Provider Demographics
NPI:1558145037
Name:CAVAZOS, CINDY Y
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:Y
Last Name:CAVAZOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1170 N CRYSTAL BEACH RD 1471
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL BEACH
Mailing Address - State:TX
Mailing Address - Zip Code:77650
Mailing Address - Country:US
Mailing Address - Phone:281-989-6986
Mailing Address - Fax:
Practice Address - Street 1:970 SURFSIDE DR
Practice Address - Street 2:
Practice Address - City:CRYSTAL BEACH
Practice Address - State:TX
Practice Address - Zip Code:77650
Practice Address - Country:US
Practice Address - Phone:281-989-6986
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-24
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX730186163W00000X, 163WI0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy