Provider Demographics
NPI:1932289360
Name:CAVINESS, ALISON (MD)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:
Last Name:CAVINESS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4515 SETON CENTER PKWY
Mailing Address - Street 2:SUITE 215
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-5290
Mailing Address - Country:US
Mailing Address - Phone:512-231-5506
Mailing Address - Fax:512-406-6216
Practice Address - Street 1:801 E WHITESTONE BLVD
Practice Address - Street 2:BLDG C
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-5028
Practice Address - Country:US
Practice Address - Phone:512-346-6611
Practice Address - Fax:512-406-7303
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2018-03-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXK04362080P0204X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX124024404Medicaid
TX124024407Medicaid
TX124024408Medicaid
8386J4Medicare ID - Type Unspecified
TX529464YKXVMedicare PIN
TX529464YKXYMedicare PIN
TX124024407Medicaid