Provider Demographics
NPI:1891168597
Name:CAPUPUS, JUAN MIGUEL (FNP-C)
Entity Type:Individual
Prefix:
First Name:JUAN MIGUEL
Middle Name:
Last Name:CAPUPUS
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6646 S STAPLES ST
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78413-5425
Mailing Address - Country:US
Mailing Address - Phone:361-334-2023
Mailing Address - Fax:
Practice Address - Street 1:6646 S STAPLES ST STE 122
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78413-5426
Practice Address - Country:US
Practice Address - Phone:361-933-5188
Practice Address - Fax:718-640-2713
Is Sole Proprietor?:No
Enumeration Date:2015-11-04
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP129466363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily