MEDICARE: LAVETTE R MINOR CMA

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	374U00000X	Home Health Aide	117450	TX

General Provider Information

NPI Number	:	1518818640
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAVETTE R MINOR CMA

Provider Business Mailing Address
First Line	:	2011 KNOLL CREST DR
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76014-3811
Country	:	US
Telephone Number	:	469-670-2369
Fax Number	:

Provider Business Practice Location Address
First Line	:	2011 KNOLL CREST DR
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76014-3811
Country	:	US
Telephone Number	:	469-670-2369
Fax Number	:

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

Provider Enumeration Date	:	02/05/2026
Last Update Date	:	02/09/2026

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Directions to “ LAVETTE R MINOR CMA” Practice Location

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