MEDICARE: CESAR A MATOS, M.D.,P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	J3549	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104024579
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CESAR A MATOS, M.D.,P.A.

Provider Business Mailing Address
First Line	:	P.O. BOX 3155
Second Line	:
City	:	MCALLEN
State	:	TX
Zip	:	78502-3155
Country	:	US
Telephone Number	:	956-289-8241
Fax Number	:	956-289-8218

Provider Business Practice Location Address
First Line	:	2110 W TRENTON RD STE A
Second Line	:
City	:	EDINBURG
State	:	TX
Zip	:	78539-4683
Country	:	US
Telephone Number	:	956-289-8241
Fax Number	:	956-289-8218

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	LAURA MATOS
Credential	:	M.D.
Telephone Number	:	956-289-8241

Provider Enumeration Date	:	07/06/2007
Last Update Date	:	02/23/2010

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