Provider Demographics
NPI:1306348552
Name:CAVAZOS, ANA DELIA (LVN)
Entity type:Individual
Prefix:MS
First Name:ANA
Middle Name:DELIA
Last Name:CAVAZOS
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 573
Mailing Address - Street 2:
Mailing Address - City:BISHOP
Mailing Address - State:TX
Mailing Address - Zip Code:78343-0573
Mailing Address - Country:US
Mailing Address - Phone:361-658-3212
Mailing Address - Fax:
Practice Address - Street 1:800 N SHORELINE BLVD STE 700
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78401-3771
Practice Address - Country:US
Practice Address - Phone:361-937-7887
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-04
Last Update Date:2018-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX126135164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse