MEDICARE: RAUL R CAPITAINE MD

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	2084P0800X	Psychiatry Physician	H4885	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	8AW409	OTHER	TX	BC/BS OF TX

General Provider Information

NPI Number	:	1568457315
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAUL R CAPITAINE MD

Provider Business Mailing Address
First Line	:	PO BOX 271190
Second Line	:
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78427-1190
Country	:	US
Telephone Number	:	361-993-4835
Fax Number	:	361-993-7043

Provider Business Practice Location Address
First Line	:	6000 S STAPLES ST
Second Line	:	#406
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78413-2952
Country	:	US
Telephone Number	:	361-993-4835
Fax Number	:	361-993-7043

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/19/2005
Last Update Date	:	10/01/2013

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Directions to “ RAUL R CAPITAINE MD” Practice Location

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