Basic Information
Provider Information
NPI: 1053365023
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ARAUJO
FirstName: JULIO
MiddleName: CESAR
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 16620 N US HIGHWAY 281 STE 300
Address2:  
City: SAN ANTONIO
State: TX
PostalCode: 782322679
CountryCode: US
TelephoneNumber: 2106141231
FaxNumber: 2104990811
Practice Location
Address1: 11481 TOEPPERWEIN RD STE 1202
Address2:  
City: LIVE OAK
State: TX
PostalCode: 782333146
CountryCode: US
TelephoneNumber: 2106558470
FaxNumber: 2109670276
Other Information
ProviderEnumerationDate: 05/22/2006
LastUpdateDate: 10/27/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/27/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RN0300XM3454TXY Allopathic & Osteopathic PhysiciansInternal MedicineNephrology

ID Information
IDTypeStateIssuerDescription
00414U01 GROUP MEDICARE LEGACY IDOTHER


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