Provider Demographics
NPI:1205368586
Name:MORALES, CESAR GERARDO (PA-C)
Entity Type:Individual
Prefix:
First Name:CESAR
Middle Name:GERARDO
Last Name:MORALES
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11888 BELFRY PARK DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-0899
Mailing Address - Country:US
Mailing Address - Phone:915-630-5145
Mailing Address - Fax:
Practice Address - Street 1:200 LISBON ST
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79905-4604
Practice Address - Country:US
Practice Address - Phone:915-630-5145
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-28
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA11180363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant