MEDICARE: DR. ROGELIO GARCIA-CAVAZOS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	L7387	TX
2	207RR0500X	Rheumatology Physician	L7387	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	8K5416	OTHER	TX	BLUE CROSS BLUE SHIELD
5	P00175266	OTHER	TX	PALMETTO GBA

General Provider Information

NPI Number	:	1275579336
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROGELIO GARCIA-CAVAZOS M.D.

Provider Business Mailing Address
First Line	:	4848 NE STALLINGS DR
Second Line	:	SUITE 205
City	:	NACOGDOCHES
State	:	TX
Zip	:	75965-1239
Country	:	US
Telephone Number	:	936-568-3364
Fax Number	:	936-462-4450

Provider Business Practice Location Address
First Line	:	4848 NE STALLINGS DR
Second Line	:	SUITE 205
City	:	NACOGDOCHES
State	:	TX
Zip	:	75965-1239
Country	:	US
Telephone Number	:	936-568-3364
Fax Number	:	936-462-4450

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/20/2006
Last Update Date	:	12/11/2013

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Directions to “ DR. ROGELIO GARCIA-CAVAZOS M.D.” Practice Location

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