Provider Demographics
NPI:1033300942
Name:CAPSTONE FAMILY PRACTICE, P.A.
Entity Type:Organization
Organization Name:CAPSTONE FAMILY PRACTICE, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:SPAFFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-866-7080
Mailing Address - Street 1:6401 CYPRESSWOOD DR
Mailing Address - Street 2:SUITE 180
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-8199
Mailing Address - Country:US
Mailing Address - Phone:281-866-7080
Mailing Address - Fax:281-866-7151
Practice Address - Street 1:6401 CYPRESSWOOD DR
Practice Address - Street 2:SUITE 180
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-8199
Practice Address - Country:US
Practice Address - Phone:281-866-7080
Practice Address - Fax:281-866-7151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-06
Last Update Date:2014-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK4804207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX092394801Medicaid
TX8F0278Medicare PIN
TX8P9170Medicare UPIN
TXI30146Medicare UPIN
TX8F0277Medicare PIN