Provider Demographics
NPI:1902038979
Name:CAVAZOS, JO-MARIE
Entity Type:Individual
Prefix:
First Name:JO-MARIE
Middle Name:
Last Name:CAVAZOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5850 SAN FELIPE ST
Mailing Address - Street 2:SUITE 500
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-3070
Mailing Address - Country:US
Mailing Address - Phone:713-706-6180
Mailing Address - Fax:713-706-6178
Practice Address - Street 1:5850 SAN FELIPE ST
Practice Address - Street 2:SUITE 500
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-3070
Practice Address - Country:US
Practice Address - Phone:713-706-6180
Practice Address - Fax:713-706-6178
Is Sole Proprietor?:No
Enumeration Date:2009-08-10
Last Update Date:2009-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist