Provider Demographics
NPI:1023024742
Name:KAPU, AMEETA (MD)
Entity Type:Individual
Prefix:
First Name:AMEETA
Middle Name:
Last Name:KAPU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1904 PINE ST STE 4A
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79601-2450
Mailing Address - Country:US
Mailing Address - Phone:325-670-4020
Mailing Address - Fax:888-437-1271
Practice Address - Street 1:1850 HICKORY ST
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79601-2325
Practice Address - Country:US
Practice Address - Phone:325-670-3970
Practice Address - Fax:325-670-3979
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK0500174400000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX752768101OtherTAXPAYER ID
TX030980901Medicaid
TX0014CUOtherBCBS PROVIDER NUMBER
TX0014CUOtherBCBS PROVIDER NUMBER
TX752768101OtherTAXPAYER ID