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General NPI Number Information
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NPI Number | 1295766228
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Entity Type | Organization
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Legal Business Name | EDUARDO O CAVEDA MD PA
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Dates
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Enumeration Date | 07/06/2006
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Last Update Date | 01/03/2008
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Provider Practice Location Address
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Address Line | 110 ARMSTRONG STREET BOX 1290
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City | ORANGE GROVE
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State | TX
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Zip | 78372
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Country | US
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Telephone | 361-384-0909
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Fax | 361-384-9998
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Provider Business Mailing Address
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Address Line | 110 ARMSTRONG STREET BOX 1290
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City | ORANGE GROVE
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State | TX
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Zip | 78372
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Country | US
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Telephone | 361-384-0909
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Fax | 361-384-9998
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Authorized Official
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Title or Position | OWNER
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Name | DR. EDUARDO OTTO CAVEDA
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Credential | M.D.
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Telephone | 361-384-0909
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number | K4017
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License Number State | TX
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