Provider Demographics
NPI:1730206293
Name:ANDINO, CESAR AUGUSTO (MD)
Entity type:Individual
Prefix:
First Name:CESAR
Middle Name:AUGUSTO
Last Name:ANDINO
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 17225
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77496-7225
Mailing Address - Country:US
Mailing Address - Phone:713-777-1435
Mailing Address - Fax:
Practice Address - Street 1:7789 SOUTHWEST FWY
Practice Address - Street 2:SUITE 125
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-1829
Practice Address - Country:US
Practice Address - Phone:713-777-1435
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2013-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK3670207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX179695501Medicaid
TX179695502OtherTEXAS HEALTH STEPS
TX8226B9Medicare PIN
TX179695502OtherTEXAS HEALTH STEPS