Provider Demographics
NPI:1720393283
Name:JOSE A CAPELLAN M.D.P.A.
Entity Type:Organization
Organization Name:JOSE A CAPELLAN M.D.P.A.
Other - Org Name:CENTER FOR ARTHRITIS AND RESPIRATORY DISEASES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:A
Authorized Official - Last Name:CAPELLAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:936-634-0527
Mailing Address - Street 1:3 MEDICAL CENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75904-3173
Mailing Address - Country:US
Mailing Address - Phone:936-634-0527
Mailing Address - Fax:936-634-0534
Practice Address - Street 1:3 MEDICAL CENTER BLVD
Practice Address - Street 2:
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75904-3173
Practice Address - Country:US
Practice Address - Phone:936-634-0527
Practice Address - Fax:936-634-0534
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-09
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK0662207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX029471201Medicaid
TX029471201Medicaid