Provider Demographics
NPI:1104024579
Name:CESAR A MATOS, M.D.,P.A.
Entity type:Organization
Organization Name:CESAR A MATOS, M.D.,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:MATOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-289-8241
Mailing Address - Street 1:P.O. BOX 3155
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78502-3155
Mailing Address - Country:US
Mailing Address - Phone:956-289-8241
Mailing Address - Fax:956-289-8218
Practice Address - Street 1:2110 W TRENTON RD STE A
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-4683
Practice Address - Country:US
Practice Address - Phone:956-289-8241
Practice Address - Fax:956-289-8218
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-06
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ35492084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX110567801Medicaid
TX005732Medicare ID - Type Unspecified
TX110567801Medicaid