Provider Demographics
NPI:1073327706
Name:CAVAZOS, GLORIA SUEHAYNE (FNP)
Entity type:Individual
Prefix:
First Name:GLORIA
Middle Name:SUEHAYNE
Last Name:CAVAZOS
Suffix:
Gender:
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25389 RABB RD
Mailing Address - Street 2:
Mailing Address - City:LA FERIA
Mailing Address - State:TX
Mailing Address - Zip Code:78559-4797
Mailing Address - Country:US
Mailing Address - Phone:956-793-1525
Mailing Address - Fax:
Practice Address - Street 1:2004 E. EXPRESSWAY 83
Practice Address - Street 2:
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78599
Practice Address - Country:US
Practice Address - Phone:956-968-3202
Practice Address - Fax:956-968-3211
Is Sole Proprietor?:No
Enumeration Date:2025-02-04
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1181869363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily