Provider Demographics
NPI:1790265718
Name:CAVANAUGH HEALTHCARE ASSOCIATES PLLC
Entity Type:Organization
Organization Name:CAVANAUGH HEALTHCARE ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:JAY
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVAI
Authorized Official - Suffix:
Authorized Official - Credentials:AEMT, PHIC
Authorized Official - Phone:210-718-9965
Mailing Address - Street 1:2552 PETTUS DR
Mailing Address - Street 2:
Mailing Address - City:FORNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75126-4158
Mailing Address - Country:US
Mailing Address - Phone:214-523-9645
Mailing Address - Fax:469-925-2831
Practice Address - Street 1:9696 SKILLMAN ST STE 220
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-8316
Practice Address - Country:US
Practice Address - Phone:469-399-0380
Practice Address - Fax:469-925-2831
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-20
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Single Specialty
No251E00000XAgenciesHome HealthGroup - Single Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty