Provider Demographics
NPI:1720075690
Name:CAPPER, DAVID PAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:PAUL
Last Name:CAPPER
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 1:1300 W. TERRELL
Mailing Address - Street 2:#500
Mailing Address - City:FT. WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104
Mailing Address - Country:US
Mailing Address - Phone:817-252-5000
Mailing Address - Fax:817-252-5060
Practice Address - Street 1:1300 W TERRELL
Practice Address - Street 2:#500
Practice Address - City:FT. WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104
Practice Address - Country:US
Practice Address - Phone:817-252-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-05
Last Update Date:2011-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG3213207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX137493612Medicaid
TX137493611Medicaid
TX010022175OtherRAIL ROAD MEDICARE
TX85K203OtherBLUE CROSS
TX137493612Medicaid
TX010022175OtherRAIL ROAD MEDICARE
TX85K203Medicare PIN
B21684Medicare UPIN
TX137493611Medicaid
8B7048Medicare PIN
TXTXB118709Medicare PIN