Provider Demographics
NPI:1629031547
Name:CAPEHART, RAEANN GRAYBILL (MD)
Entity type:Individual
Prefix:DR
First Name:RAEANN
Middle Name:GRAYBILL
Last Name:CAPEHART
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1151 N BUCKNER BLVD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75218-3403
Mailing Address - Country:US
Mailing Address - Phone:214-321-3536
Mailing Address - Fax:214-321-3520
Practice Address - Street 1:1151 N BUCKNER BLVD
Practice Address - Street 2:SUITE 105
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75218-3426
Practice Address - Country:US
Practice Address - Phone:214-321-3536
Practice Address - Fax:214-321-3520
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXG9437208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery