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General NPI Number Information
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NPI Number | 1003145483
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Entity Type | Organization
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Legal Business Name | DOCTOR AT YOUR SERVICE PLLC
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Dates
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Enumeration Date | 12/15/2009
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 4242 MEDICAL DR SUITE 6250
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City | SAN ANTONIO
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State | TX
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Zip | 78229
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Country | US
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Telephone | 210-479-3297
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Fax | 210-479-3295
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Provider Business Mailing Address
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Address Line | 4242 MEDICAL DR SUITE 6250
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City | SAN ANTONIO
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State | TX
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Zip | 78229
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Country | US
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Telephone | 210-479-3297
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Fax | 210-479-3295
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Authorized Official
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Title or Position | PRESIDENT/PHYSICIAN
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Name | ANTONIO CAVAZOS JR.
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Credential | M.D.
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Telephone | 210-479-3297
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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