Provider Demographics
NPI:1386695906
Name:DUCLAIR, CESAR P (MD)
Entity type:Individual
Prefix:
First Name:CESAR
Middle Name:P
Last Name:DUCLAIR
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 1:2601 SCOTT AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76103-2301
Mailing Address - Country:US
Mailing Address - Phone:817-377-4011
Mailing Address - Fax:817-377-9269
Practice Address - Street 1:2601 SCOTT AVE STE 102
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76103-2301
Practice Address - Country:US
Practice Address - Phone:817-377-4011
Practice Address - Fax:817-377-9269
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN2064208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
I32856Medicare UPIN