Provider Demographics
NPI:1033427984
Name:SHELLEY CAPEHART MD PA
Entity Type:Organization
Organization Name:SHELLEY CAPEHART MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHELLEY
Authorized Official - Middle Name:L
Authorized Official - Last Name:CAPEHART
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:915-351-6020
Mailing Address - Street 1:661 S MESA HILLS DR
Mailing Address - Street 2:STE 102
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-5550
Mailing Address - Country:US
Mailing Address - Phone:800-522-1952
Mailing Address - Fax:575-532-7006
Practice Address - Street 1:1700 N OREGON ST
Practice Address - Street 2:STE 500
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-3581
Practice Address - Country:US
Practice Address - Phone:915-351-6020
Practice Address - Fax:915-351-6048
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-14
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty