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General NPI Number Information
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NPI Number | 1104024579
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Entity Type | Organization
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Legal Business Name | CESAR A MATOS, M.D.,P.A.
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Dates
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Enumeration Date | 07/06/2007
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Last Update Date | 02/23/2010
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Provider Practice Location Address
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Address Line | 2110 W TRENTON RD STE A
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City | EDINBURG
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State | TX
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Zip | 78539-4683
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Country | US
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Telephone | 956-289-8241
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Fax | 956-289-8218
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Provider Business Mailing Address
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Address Line | P.O. BOX 3155
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City | MCALLEN
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State | TX
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Zip | 78502-3155
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Country | US
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Telephone | 956-289-8241
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Fax | 956-289-8218
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | LAURA MATOS
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Credential | M.D.
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Telephone | 956-289-8241
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | J3549
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License Number State | TX
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