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NPI Code Detail

MEDICARE: JOSE ADRIAN CAVAZOS

MEDICARE: JOSE ADRIAN CAVAZOS
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
1106S00000XBehavior Technician20-13664TX

General Provider Information

NPI Number : 1720654551
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSE ADRIAN CAVAZOS
Provider Business Mailing Address
First Line : 2825 VALLEY VIEW LN STE 100
Second Line :
City : FARMERS BRANCH
State : TX
Zip : 75234-4943
Country : US
Telephone Number : 214-736-8376
Fax Number : 214-377-4942
Provider Business Practice Location Address
First Line : 2825 VALLEY VIEW LN STE 100
Second Line :
City : FARMERS BRANCH
State : TX
Zip : 75234-4943
Country : US
Telephone Number : 214-736-8376
Fax Number : 214-377-4942
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2021
Last Update Date : 06/02/2021

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Directions to “ JOSE ADRIAN CAVAZOS ” Practice Location

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