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NPI Code Detail

MEDICARE: MR. CESAR R JAZMIN III PA-C

MEDICARE: MR. CESAR R JAZMIN III PA-C
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
1363AM0700XMedical Physician AssistantPA9113843FL
2363A00000XPhysician AssistantPA09925TX
3363A00000XPhysician AssistantPA9113843FL

Other Identifiers

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

General Provider Information

NPI Number : 1932438520
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. CESAR R JAZMIN III PA-C
Provider Business Mailing Address
First Line : PO BOX 844658
Second Line :
City : DALLAS
State : TX
Zip : 75284-4658
Country : US
Telephone Number : 254-724-2111
Fax Number :
Provider Business Practice Location Address
First Line : 1507 RIVERY BLVD
Second Line :
City : GEORGETOWN
State : TX
Zip : 78628-3058
Country : US
Telephone Number : 512-509-9550
Fax Number : 512-509-9555
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/10/2009
Last Update Date : 10/10/2023

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