Provider Demographics
NPI:1952666331
Name:CAVAZOS, JAVEN VALERIE (MD)
Entity Type:Individual
Prefix:
First Name:JAVEN
Middle Name:VALERIE
Last Name:CAVAZOS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JAVEN
Other - Middle Name:VALERIE
Other - Last Name:FERMO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:17806 W INTERSTATE 10 STE 300
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78257-8222
Mailing Address - Country:US
Mailing Address - Phone:830-476-0929
Mailing Address - Fax:830-239-9760
Practice Address - Street 1:17806 W INTERSTATE 10 STE 300
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78257-8222
Practice Address - Country:US
Practice Address - Phone:830-476-0929
Practice Address - Fax:830-239-9760
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-11
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2653762084P0800X
TXP50472084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry