Provider Demographics
NPI:1013931468
Name:TEXAS CPC MEDICAL INC.
Entity Type:Organization
Organization Name:TEXAS CPC MEDICAL INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CESAR
Authorized Official - Middle Name:ANTONIO
Authorized Official - Last Name:GUERRERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-546-1495
Mailing Address - Street 1:1313 E ALTON GLOOR BLVD STE I
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78526-3909
Mailing Address - Country:US
Mailing Address - Phone:956-544-7474
Mailing Address - Fax:956-621-2301
Practice Address - Street 1:1313 E ALTON GLOOR BLVD
Practice Address - Street 2:SUITE I
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78526-3909
Practice Address - Country:US
Practice Address - Phone:956-544-7474
Practice Address - Fax:956-621-2301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX188543602Medicaid
TX188543601OtherMEDICAID SUFFIX 01 CCP
TX188543602Medicaid