Provider Demographics
NPI:1720042633
Name:SEVILLA, CESAR AUGUSTO (MD)
Entity Type:Individual
Prefix:DR
First Name:CESAR
Middle Name:AUGUSTO
Last Name:SEVILLA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:7119 SAVANNAH GLEN LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-7347
Mailing Address - Country:US
Mailing Address - Phone:409-771-9227
Mailing Address - Fax:
Practice Address - Street 1:7324 SOUTHWEST FWY STE 1423
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-2172
Practice Address - Country:US
Practice Address - Phone:409-771-9227
Practice Address - Fax:281-762-2732
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2020-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG2479207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX097977504OtherINDIVIDUAL TPI NUMBER
TXMDG2479TXOtherWORKERS COMPENSATION
TXTXB136894OtherGROUP PTAN NUMBER
TX287506401OtherTPI GROUP NUMBER
TXP00173648OtherRAILROAD GBA - RAILROAD MEDICARE
TXTXB136895OtherINDIVIDUAL PTAN NUMBER
TX097977503Medicaid
TX8G6217OtherBC/BS TX#
TXTXB150867OtherGROUP PTAN NUMBER
TXTXB136895OtherINDIVIDUAL PTAN NUMBER
TXC21630Medicare UPIN