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NPI Code Detail

MEDICARE: CAPSTONE-HOUSTON OPCO LLC

MEDICARE: CAPSTONE-HOUSTON OPCO LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility

General Provider Information

NPI Number : 1144786823
Entity Type Code : Organization
Provider Name (Legal Business Name) : CAPSTONE-HOUSTON OPCO LLC
Provider Business Mailing Address
First Line : 3730 W OREM DR
Second Line :
City : HOUSTON
State : TX
Zip : 77045-4426
Country : US
Telephone Number : 832-405-6245
Fax Number : 713-534-1691
Provider Business Practice Location Address
First Line : 3730 W OREM DR
Second Line :
City : HOUSTON
State : TX
Zip : 77045-4426
Country : US
Telephone Number : 832-405-6245
Fax Number : 713-534-1691
Authorized Official
Title or Position : MANAGER
Name : MATTT MOMAN
Credential :
Telephone Number : 469-712-6025
Provider Enumeration Date : 02/18/2019
Last Update Date : 07/16/2020

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Directions to “CAPSTONE-HOUSTON OPCO LLC ” Practice Location

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