Provider Demographics
NPI:1013027143
Name:CAPROCK MEDICAL ASSOCIATES, P.A.
Entity Type:Organization
Organization Name:CAPROCK MEDICAL ASSOCIATES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ELMORE
Authorized Official - Middle Name:'JACK'
Authorized Official - Last Name:MCCARTY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:806-791-5140
Mailing Address - Street 1:PO BOX 54136
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79453-4136
Mailing Address - Country:US
Mailing Address - Phone:806-771-1386
Mailing Address - Fax:806-771-1388
Practice Address - Street 1:3802 21ST ST
Practice Address - Street 2:C
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79410-1011
Practice Address - Country:US
Practice Address - Phone:806-791-5140
Practice Address - Fax:806-791-0454
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0055EMOtherBCBS
TX0055EMOtherBCBS