Healthcare Provider Details

I. General information

NPI: 1619977055
Provider Name (Legal Business Name): RAMIRO D CAVAZOS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2005
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9618 HUEBNER RD STE 202
SAN ANTONIO TX
78240-1776
US

IV. Provider business mailing address

9618 HUEBNER RD STE 202
SAN ANTONIO TX
78240-1776
US

V. Phone/Fax

Practice location:
  • Phone: 210-651-0303
  • Fax: 210-651-0302
Mailing address:
  • Phone: 210-651-0303
  • Fax: 210-651-0302

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberM1571
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: