Provider Demographics
NPI:1629111356
Name:CESAR A ANDINO MD PA
Entity Type:Organization
Organization Name:CESAR A ANDINO MD PA
Other - Org Name:CESAR A ANDINO MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CESAR
Authorized Official - Middle Name:AUGUSTO
Authorized Official - Last Name:ANDINO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-777-1435
Mailing Address - Street 1:PO BOX 17225
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77496-7225
Mailing Address - Country:US
Mailing Address - Phone:713-777-1435
Mailing Address - Fax:713-777-2308
Practice Address - Street 1:7789 SOUTHWEST FWY STE 125
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-1832
Practice Address - Country:US
Practice Address - Phone:713-777-1435
Practice Address - Fax:713-777-2308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2011-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX10032033Medicaid
TX179695501Medicaid
TX179695502Medicaid
TX179695501Medicaid
TX179695502Medicaid