Organization
DR. CESAR PENA MD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA JACKSON (MANAGER)
(817) 565-3288
Entity
Organization
Contact information
Practice address
3232 BROADWAY BLVD STE A, GARLAND, TX 75043-1728
(972) 905-5134
Mailing address
9101 LBJ FWY STE 425, DALLAS, TX 75243-2057
(817) 565-3288
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
L7105
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1073576435
INDIVIDUAL NPI
TX
Enumeration date
02/27/2018
Last updated
02/27/2018
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