Healthcare Provider Details

I. General information

NPI: 1467418863
Provider Name (Legal Business Name): LUIZ G CESAR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/25/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3502 9TH ST SUITE 240
LUBBOCK TX
79415-3300
US

IV. Provider business mailing address

5219 CITY BANK PKWY SUITE 135
LUBBOCK TX
79407-3544
US

V. Phone/Fax

Practice location:
  • Phone: 806-761-0737
  • Fax: 806-761-0738
Mailing address:
  • Phone: 806-785-7676
  • Fax: 806-722-2908

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License NumberK6545
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: