Provider Demographics
NPI:1649451725
Name:DIAS, CESAR AUGUSTO (MD)
Entity type:Individual
Prefix:
First Name:CESAR
Middle Name:AUGUSTO
Last Name:DIAS
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 1:1625 MEDICAL CENTER DR
Mailing Address - Street 2:EMERGENCY DEPARTMENT
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-5005
Mailing Address - Country:US
Mailing Address - Phone:915-747-2660
Mailing Address - Fax:
Practice Address - Street 1:4800 ALBERTA AVE
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79905-2709
Practice Address - Country:US
Practice Address - Phone:915-743-7333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-17
Last Update Date:2013-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM7141207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX192694110Medicaid
TX257912YKN5Medicare PIN