Provider Demographics
NPI:1952390809
Name:CAVUOTI, CLINTON PETER JR (MD)
Entity Type:Individual
Prefix:
First Name:CLINTON
Middle Name:PETER
Last Name:CAVUOTI
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 5409
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79608-5409
Mailing Address - Country:US
Mailing Address - Phone:325-670-6458
Mailing Address - Fax:325-670-6498
Practice Address - Street 1:1150 N 18TH ST
Practice Address - Street 2:SUITE 300
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79601-2948
Practice Address - Country:US
Practice Address - Phone:325-670-6458
Practice Address - Fax:365-670-6498
Is Sole Proprietor?:No
Enumeration Date:2005-10-13
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXF3821207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX838059Medicare PIN
TXC14318Medicare UPIN
TX838059Medicare ID - Type Unspecified