Provider Demographics
NPI:1841265279
Name:CESAR, CARLOS R (MD)
Entity type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:R
Last Name:CESAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:CARLOS
Other - Middle Name:R
Other - Last Name:CESAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 12546
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79913-0546
Mailing Address - Country:US
Mailing Address - Phone:915-595-0067
Mailing Address - Fax:
Practice Address - Street 1:2295 TRAWOOD DR
Practice Address - Street 2:SUITE B
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79935-3054
Practice Address - Country:US
Practice Address - Phone:915-595-0067
Practice Address - Fax:915-595-0094
Is Sole Proprietor?:No
Enumeration Date:2006-02-20
Last Update Date:2011-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL 2836207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX151890401Medicaid