Provider Demographics
NPI:1932686649
Name:CAVAZOS, MONICA ISELA (RN)
Entity Type:Individual
Prefix:MRS
First Name:MONICA
Middle Name:ISELA
Last Name:CAVAZOS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3310 GREENWOOD GLEN DR
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77345-1119
Mailing Address - Country:US
Mailing Address - Phone:832-228-3371
Mailing Address - Fax:
Practice Address - Street 1:3310 GREENWOOD GLEN DR
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77345-1119
Practice Address - Country:US
Practice Address - Phone:832-228-3371
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-25
Last Update Date:2018-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX914148163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse