Healthcare Provider Details

I. General information

NPI: 1366186447
Provider Name (Legal Business Name): ELEEMOSYNANT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2022
Last Update Date: 06/26/2025
Certification Date: 06/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 E VANCE ST
REFUGIO TX
78377-4421
US

IV. Provider business mailing address

126 POMPANO AVE
GALVESTON TX
77550-3130
US

V. Phone/Fax

Practice location:
  • Phone: 409-771-8516
  • Fax: 361-349-3027
Mailing address:
  • Phone: 409-771-8516
  • Fax: 409-220-8350

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KAREL CAPEK
Title or Position: OWNER
Credential: MD
Phone: 409-771-8516