Provider Demographics
NPI:1164017638
Name:ZAYAS, CAPRECIA
Entity Type:Individual
Prefix:
First Name:CAPRECIA
Middle Name:
Last Name:ZAYAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 NE LOOP 410 STE 400
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-5834
Mailing Address - Country:US
Mailing Address - Phone:210-214-2111
Mailing Address - Fax:
Practice Address - Street 1:45 NE LOOP 410 STE 400
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-5834
Practice Address - Country:US
Practice Address - Phone:210-214-2111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-05
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARDA91087261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental