San Juanita A Cavazos, SLP-A

Individual provider Active NPI Speech-Language Assistant · San Benito, TX

NPI 1164617809 · NPPES record last updated Apr 23, 2021

Key facts

NPI
1164617809
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Assistant 2355S0801X
License
32976 (TX)
Practice address
711 N Sam Houston Blvd
San Benito, TX 78586-5264
Phone
(956) 626-3366
NPI assigned
Sep 6, 2007
Sex
Female
Sole proprietor
Yes

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
32976TXMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Nova Primary Home Care, LLC Current
since Jul 1, 2021
Accepting new patients

Locations

711 N Sam Houston Blvd
San Benito, TX 78586
Phone (956) 626-3366

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant 2355S0801X 32976 TX Yes

Addresses

Primary practice location

711 N Sam Houston Blvd
San Benito, TX 78586-5264

Mailing address

611 Garrison Dr
San Benito, TX 78586-5021
Phone (956) 244-0032

Other providers in San Benito, TX

All providers in San Benito, TX · Speech-Language Assistant in Texas

Sources for this page

Verify at the official NPI Registry.