Provider Demographics
NPI:1609128404
Name:CAVA, ALEX L (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ALEX
Middle Name:L
Last Name:CAVA
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5926 S STAPLES ST STE D9
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78413-3843
Mailing Address - Country:US
Mailing Address - Phone:304-617-2387
Mailing Address - Fax:361-992-6835
Practice Address - Street 1:5926 S STAPLES ST STE D9
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78413-3843
Practice Address - Country:US
Practice Address - Phone:304-617-2387
Practice Address - Fax:361-992-6835
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-04
Last Update Date:2015-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36754103TC0700X
VA0810004671103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical