Provider Demographics
NPI:1891719357
Name:KAPU, GOPICHAND (MD)
Entity Type:Individual
Prefix:DR
First Name:GOPICHAND
Middle Name:
Last Name:KAPU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 391
Mailing Address - Street 2:
Mailing Address - City:ANSON
Mailing Address - State:TX
Mailing Address - Zip Code:79501
Mailing Address - Country:US
Mailing Address - Phone:325-823-3296
Mailing Address - Fax:325-823-2667
Practice Address - Street 1:215 N AVE J
Practice Address - Street 2:
Practice Address - City:ANSON
Practice Address - State:TX
Practice Address - Zip Code:79501
Practice Address - Country:US
Practice Address - Phone:325-823-3296
Practice Address - Fax:325-823-2667
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2008-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF4895207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX121103903Medicaid
TX00JM08Medicare PIN