Healthcare Provider Details

I. General information

NPI: 1043361421
Provider Name (Legal Business Name): JOSEPH R. CAPPS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/14/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2113 N HIGHWAY 175 FCI SEAGOVILLE, HEALTH SERVICES
SEAGOVILLE TX
75159-2237
US

IV. Provider business mailing address

214 MANSFIELD BLVD
SUNNYVALE TX
75182-9500
US

V. Phone/Fax

Practice location:
  • Phone: 972-287-4095
  • Fax: 972-287-6769
Mailing address:
  • Phone: 972-226-2334
  • Fax: 972-287-6769

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberF-914
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: