MEDICARE: DAVID P. CAPPER, M.D., PLLC

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
1	261QP2300X	Primary Care Clinic/Center	G3213	TX

General Provider Information

NPI Number	:	1043589898
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAVID P. CAPPER, M.D., PLLC

Provider Business Mailing Address
First Line	:	3221 COLLINSWORTH ST
Second Line	:	SUITE 160
City	:	FORT WORTH
State	:	TX
Zip	:	76107-6577
Country	:	US
Telephone Number	:	817-735-8741
Fax Number	:	817-735-8836

Provider Business Practice Location Address
First Line	:	3221 COLLINSWORTH ST
Second Line	:	SUITE 160
City	:	FORT WORTH
State	:	TX
Zip	:	76107-6577
Country	:	US
Telephone Number	:	817-735-8741
Fax Number	:	817-735-8836

Authorized Official
Title or Position	:	OWNER
Name	:	DR. DAVID PAUL CAPPER
Credential	:	M.D.
Telephone Number	:	817-735-8741

Provider Enumeration Date	:	12/23/2011
Last Update Date	:	12/23/2011

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