NPIMap

Individual provider Active NPI

Cesar Iglesias, PA-C

  • Physician Assistant
  • Jbsa Lackland, TX
National Provider Identifier
1720315237
Registry record updated Dec 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA06417 Issued in TX
Practice address
1100 Wilford Hall Loop BLDG 4554
Jbsa Lackland, TX 78236-5638
Phone
(210) 292-7331
NPI assigned
Nov 5, 2009
Last updated
Dec 17, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X PA06417 TX Primary

Addresses

Primary practice location

1100 Wilford Hall Loop BLDG 4554
Jbsa Lackland, TX 78236-5638

Mailing address

1100 Wilford Hall Loop BLDG 4554
Jbsa Lackland, TX 78236-5638
Phone (210) 292-7331

Other names 1

  • Mr. Cesar Iglesias Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100216000706 TX Practitioner - Physician Assistant 6608910534 Reassigns benefits to 5 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA06417TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
TMC Provider Group PLLC CurrentSince Sep 6, 2023 Accepting new patients
TMC Provider Group, PLLC CurrentSince Sep 6, 2023 Accepting new patients
TMC Provider Group, PLLC Current Accepting new patients
Leading Edge Emergency Physicians, Inc CurrentSince Sep 3, 2017 Accepting new patients
Coastal Mobile Medical Group, PLLC PastSince Sep 1, 2019 Accepting new patients
Abk Emergency Physicians PLLC Physician Assistant Past Accepting new patients
St. David's Carenow Urgent Care PLLC Past Accepting new patients

Locations

9900 S Interstate 35
Austin, TX 78748
Phone (512) 291-5577

8465 Memorial Blvd
Ste 300
Port Arthur, TX 77640
Phone (409) 344-4220

13722 Embassy Row
San Antonio, TX 78216
Phone (210) 349-5577

16088 San Pedro Ave
San Antonio, TX 78232
Phone (210) 402-4092

23611 W Interstate 10
San Antonio, TX 78257
Phone (210) 698-6617

Organizations & group practices 12

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1257379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545004800000",
    "number": "1720315237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 WILFORD HALL LOOP BLDG 4554",
            "city": "JBSA LACKLAND",
            "state": "TX",
            "postal_code": "782365638",
            "telephone_number": "210-292-7331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 WILFORD HALL LOOP BLDG 4554",
            "city": "JBSA LACKLAND",
            "state": "TX",
            "postal_code": "782365638",
            "telephone_number": "210-292-7331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IGLESIAS",
        "first_name": "CESAR",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-11-05",
        "last_updated": "2018-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA06417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CESAR",
            "last_name": "IGLESIAS",
            "prefix": "MR.",
            "credential": "PA-C",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Jbsa Lackland, TX

Sources for this page

Verify at the official NPI Registry.