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General NPI Number Information
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NPI Number | 1083986715
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Entity Type | Organization
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Legal Business Name | MIKE CAPT MD PLLC
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Dates
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Enumeration Date | 01/26/2012
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Last Update Date | 02/09/2012
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Provider Practice Location Address
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Address Line | 300 W HALSELL ST
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City | DIMMITT
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State | TX
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Zip | 79027-1846
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Country | US
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Telephone | 806-577-7578
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Fax |
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Provider Business Mailing Address
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Address Line | 22 LINDSEY LN
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City | CANYON
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State | TX
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Zip | 79015-1832
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Country | US
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Telephone | 806-577-7578
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | ROBIN CAPT
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Credential |
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Telephone | 806-577-7578
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | N3536
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License Number State | TX
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