Provider Demographics
NPI:1487630885
Name:TULA, CESAR JORGE (MD)
Entity Type:Individual
Prefix:DR
First Name:CESAR
Middle Name:JORGE
Last Name:TULA
Suffix:
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 3150
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78044-3150
Mailing Address - Country:US
Mailing Address - Phone:956-794-8861
Mailing Address - Fax:956-726-1220
Practice Address - Street 1:1 MERCADO ST
Practice Address - Street 2:
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-7306
Practice Address - Country:US
Practice Address - Phone:970-385-7977
Practice Address - Fax:970-385-6727
Is Sole Proprietor?:No
Enumeration Date:2005-12-16
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG1788207RH0003X
CODR.0065703207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX115952705Medicaid
TX830008179OtherMEDICARE RAILROAD CARRIER
TX8AD989OtherBLUE CROSS BLUE SHIELD
TX8237B6Medicare PIN
TXC22821Medicare UPIN