Provider Demographics
NPI:1942298872
Name:CAPRA, JAY DONALD (MD)
Entity Type:Individual
Prefix:
First Name:JAY
Middle Name:DONALD
Last Name:CAPRA
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 5409
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79608-5409
Mailing Address - Country:US
Mailing Address - Phone:325-437-8655
Mailing Address - Fax:325-437-8647
Practice Address - Street 1:1665 ANTILLEY RD STE 200
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79606-5271
Practice Address - Country:US
Practice Address - Phone:325-692-5800
Practice Address - Fax:325-692-6111
Is Sole Proprietor?:No
Enumeration Date:2005-10-13
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK1746208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX118993802Medicaid
TX86Y907Medicare PIN
TX86Y907Medicare ID - Type Unspecified