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Individual

MR. CESAR ORLANDO BANUELOS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
1515 PAPPAS ST, LAREDO, TX 78041-1705
(956) 523-3683
(956) 718-6294
Mailing address
1515 PAPPAS ST, LAREDO, TX 78041-1705
(956) 523-3683
(956) 718-6294

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA06426
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PA06426
LICENSE
TX
Enumeration date
09/07/2010
Last updated
10/30/2013
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