Provider Demographics
NPI:1205895349
Name:CAVUOTI, DOMINICK CHRISTOPHER (DO)
Entity type:Individual
Prefix:
First Name:DOMINICK
Middle Name:CHRISTOPHER
Last Name:CAVUOTI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10232 ROSSER RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75229-6143
Mailing Address - Country:US
Mailing Address - Phone:214-287-2159
Mailing Address - Fax:
Practice Address - Street 1:10232 ROSSER RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75229-6143
Practice Address - Country:US
Practice Address - Phone:214-287-2159
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-18
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK2664207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX151932401Medicaid
H62447Medicare UPIN