Basic Information
| Provider Information | |||||||||
| NPI: | 1184276818 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SOUTULLO ESPERON | ||||||||
| FirstName: | CESAR | ||||||||
| MiddleName: | ALEJANDRO | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | UT HEALTH, DEPARTMENT OF PSYCHIATRY | ||||||||
| Address2: | 1941 EAST ROAD | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770546010 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7134862642 | ||||||||
| FaxNumber: | 7134862797 | ||||||||
| Practice Location | |||||||||
| Address1: | UT HEALTH, DEPARTMENT OF PSYCHIATRY | ||||||||
| Address2: | 1941 EAST ROAD | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770546010 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7134862642 | ||||||||
| FaxNumber: | 7134862797 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/12/2019 | ||||||||
| LastUpdateDate: | 05/10/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/10/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0804X | 46728 | TX | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Child & Adolescent Psychiatry | 2084P0804X | 33433 | KY | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Child & Adolescent Psychiatry | 2084P0804X | 47613 | TX | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Child & Adolescent Psychiatry |
No ID Information.