Provider Demographics
NPI:1124554308
Name:MACAPIA, MICHELLE CANASTILLO (PT)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:CANASTILLO
Last Name:MACAPIA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 REDFORD ST
Mailing Address - Street 2:APT. 312B
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77034-1863
Mailing Address - Country:US
Mailing Address - Phone:615-649-2271
Mailing Address - Fax:
Practice Address - Street 1:1401 REDFORD ST
Practice Address - Street 2:APT. 312B
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77034-1863
Practice Address - Country:US
Practice Address - Phone:615-649-2271
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-07
Last Update Date:2017-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1231790225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist