Provider Demographics
NPI:1538760806
Name:PAVLIC, CATHY GEORGE
Entity type:Individual
Prefix:
First Name:CATHY
Middle Name:GEORGE
Last Name:PAVLIC
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 1:617 S 1ST ST
Mailing Address - Street 2:
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75901-3933
Mailing Address - Country:US
Mailing Address - Phone:936-249-6160
Mailing Address - Fax:
Practice Address - Street 1:617 S 1ST ST
Practice Address - Street 2:
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75901-3933
Practice Address - Country:US
Practice Address - Phone:936-249-6160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-03
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX559131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical