Individual provider Active NPI

Homero Osvaldo Cavazos, D.C.

  • Neurology Chiropractor
  • Plano, TX
National Provider Identifier
1003068917
Registry record updated Oct 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology ChiropractorTaxonomy code 111NN0400X
License
11011 Issued in TX
Practice address
4508 Legacy Dr
Suite 200
Plano, TX 75024-2183
Phone
(214) 377-4833
Fax
(214) 377-4836
NPI assigned
Oct 22, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Chiropractor 111NN0400X 11011 TX Primary

Addresses

Primary practice location

4508 Legacy Dr
Suite 200
Plano, TX 75024-2183

Mailing address

2020 Aberdeen Ave
McKinney, TX 75070-7294
Phone (214) 914-5684

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221128000510 TX Practitioner - Chiropractic 1759759632

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11011TXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Structure Chiropractic and Physical Therapy Neurology CurrentSince Sep 12, 2022 Accepting new patients

Locations

3550 Parkwood Blvd
Ste 706
Frisco, TX 75034
Phone (214) 377-4833

4508 Legacy Dr
Ste 200
Plano, TX 75024
Phone (214) 377-4833

Networks

  • TX HMO
  • NM HMO C-SNP
  • TX HMO D-SNP

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1224633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224633600000",
    "number": "1003068917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 ABERDEEN AVE",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750707294",
            "telephone_number": "214-914-5684",
            "fax_number": "214-377-4836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4508 LEGACY DR",
            "address_2": "SUITE 200",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750242183",
            "telephone_number": "214-377-4833",
            "fax_number": "214-377-4836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAVAZOS",
        "first_name": "HOMERO",
        "middle_name": "OSVALDO",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-22",
        "last_updated": "2008-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Neurology",
            "state": "TX",
            "license": "11011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.