Provider Demographics
NPI:1780632158
Name:GOMEZ-LOZANO, CESAR AUGUSTO (MD)
Entity Type:Individual
Prefix:DR
First Name:CESAR
Middle Name:AUGUSTO
Last Name:GOMEZ-LOZANO
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 1:122 N INTERNATIONAL RD STE B
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75042-6530
Mailing Address - Country:US
Mailing Address - Phone:972-494-6713
Mailing Address - Fax:972-494-5034
Practice Address - Street 1:122 N INTERNATIONAL RD
Practice Address - Street 2:SUITE B
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75042-6530
Practice Address - Country:US
Practice Address - Phone:972-494-6173
Practice Address - Fax:972-494-5034
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ5332207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX130915501Medicaid
TX83820YOtherBLUECROSS/BLUESHIELD
TX110201873OtherRAILROAD MEDICARE
TX130915501Medicaid
TX00123DMedicare PIN