Provider Demographics
NPI:1285161109
Name:PEREZ, CESAR AGUSTIN (MD)
Entity type:Individual
Prefix:
First Name:CESAR
Middle Name:AGUSTIN
Last Name:PEREZ
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:PO BOX 29343
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-2045
Mailing Address - Country:US
Mailing Address - Phone:903-232-8290
Mailing Address - Fax:903-237-1810
Practice Address - Street 1:2901 N 4TH STREET
Practice Address - Street 2:LRMC HOSPITALIST
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75605-7560
Practice Address - Country:US
Practice Address - Phone:903-758-1818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-23
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS6709207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine