Provider Demographics
NPI:1649383571
Name:EDUARDO O. CAVEDA MD PA
Entity Type:Organization
Organization Name:EDUARDO O. CAVEDA MD PA
Other - Org Name:CAVEDA CARE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EDUARDO
Authorized Official - Middle Name:OTTO
Authorized Official - Last Name:CAVEDA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:361-384-0909
Mailing Address - Street 1:102 E KING AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:TX
Mailing Address - Zip Code:78384-1838
Mailing Address - Country:US
Mailing Address - Phone:361-279-8804
Mailing Address - Fax:361-279-8812
Practice Address - Street 1:102 E KING AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:TX
Practice Address - Zip Code:78384-1838
Practice Address - Country:US
Practice Address - Phone:361-279-8804
Practice Address - Fax:361-279-8812
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health