Provider Demographics
NPI:1225019136
Name:DELAGUILA, CESAR (MD)
Entity type:Individual
Prefix:DR
First Name:CESAR
Middle Name:
Last Name:DELAGUILA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1710 COUNTY ROAD 811
Mailing Address - Street 2:
Mailing Address - City:NACOGDOCHES
Mailing Address - State:TX
Mailing Address - Zip Code:75964-1805
Mailing Address - Country:US
Mailing Address - Phone:936-645-5854
Mailing Address - Fax:936-462-8761
Practice Address - Street 1:3440 NE STALLINGS DR
Practice Address - Street 2:
Practice Address - City:NACOGDOCHES
Practice Address - State:TX
Practice Address - Zip Code:75965-8719
Practice Address - Country:US
Practice Address - Phone:936-645-5854
Practice Address - Fax:936-462-8761
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-08
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMD27006207RC0000X
TXM5124207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX186245001Medicaid
TX186244301Medicaid
TXF82832Medicare UPIN
TX8F4503Medicare PIN
LA1991244Medicaid