Provider Demographics
NPI:1275517906
Name:TERMULO, CESAR JR (MD)
Entity Type:Individual
Prefix:
First Name:CESAR
Middle Name:
Last Name:TERMULO
Suffix:JR
Gender:M
Credentials:MD
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 660599
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75266-0599
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3320 LIVE OAK ST
Practice Address - Street 2:EAST DALLAS HEALTH CENTER
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75204-6109
Practice Address - Country:US
Practice Address - Phone:214-266-1000
Practice Address - Fax:214-266-1128
Is Sole Proprietor?:No
Enumeration Date:2005-12-06
Last Update Date:2012-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK7219208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX100753607Medicaid
TX100753617Medicaid
TX80414GOtherBLUE CROSS BLUE SHIELD
TX100753601Medicaid
TX100753604Medicaid
TX100753602Medicaid
TX100753609Medicaid
TX100753605Medicaid
TX100753608Medicaid
TX100753615Medicaid
TX100753606Medicaid
TX100753611Medicaid
TX100753613Medicaid
TX100753616Medicaid
TX100753602Medicaid
TX80414GMedicare PIN