Provider Demographics
NPI:1790805877
Name:ROHIT KAPOOR MD PA
Entity type:Organization
Organization Name:ROHIT KAPOOR MD PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BILLING ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:PARKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-655-0075
Mailing Address - Street 1:PO BOX 676596
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75267-6596
Mailing Address - Country:US
Mailing Address - Phone:210-655-0075
Mailing Address - Fax:210-655-2117
Practice Address - Street 1:12602 TOEPPERWEIN RD STE 114
Practice Address - Street 2:
Practice Address - City:LIVE OAK
Practice Address - State:TX
Practice Address - Zip Code:78233-3270
Practice Address - Country:US
Practice Address - Phone:210-655-0075
Practice Address - Fax:210-655-2117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ5369207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX129591707Medicaid
TX00039SOtherBLUE CROSS BLUE SHIELD
TXDG8239OtherMEDICARE RAILROAD CARRIER
TXDG8239OtherMEDICARE RAILROAD CARRIER
TX00039SOtherBLUE CROSS BLUE SHIELD
TXDG8239OtherMEDICARE RAILROAD CARRIER
TX=========OtherHUMANA
TX=========OtherTRICARE SOUTH