Provider Demographics
NPI:1770938029
Name:CAVAZOS, ROBERTO HERNAN JR (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERTO
Middle Name:HERNAN
Last Name:CAVAZOS
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2121 HEPBURN ST
Mailing Address - Street 2:APT 301
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-3242
Mailing Address - Country:US
Mailing Address - Phone:956-605-6437
Mailing Address - Fax:
Practice Address - Street 1:2121 HEPBURN ST
Practice Address - Street 2:APT 301
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-3242
Practice Address - Country:US
Practice Address - Phone:956-605-6437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-24
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10056221207R00000X
TXS0645208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine