Provider Demographics
NPI:1982977088
Name:MUNOZ, CESAR OMAR (PA)
Entity Type:Individual
Prefix:
First Name:CESAR
Middle Name:OMAR
Last Name:MUNOZ
Suffix:
Gender:M
Credentials:PA
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Other - First Name:
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Mailing Address - Street 1:1139 E SONTERRA BLVD
Mailing Address - Street 2:STE 500
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-4352
Mailing Address - Country:US
Mailing Address - Phone:469-282-2711
Mailing Address - Fax:469-282-2609
Practice Address - Street 1:613 ELIZABETH ST STE 804
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78404-2231
Practice Address - Country:US
Practice Address - Phone:361-881-3351
Practice Address - Fax:361-861-9022
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-21
Last Update Date:2017-03-21
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX296958602Medicaid
TX494087YMJMMedicare PIN