Provider Demographics
NPI:1104146125
Name:JOHN E, CAPEHART, M.D., P.A.
Entity type:Organization
Organization Name:JOHN E, CAPEHART, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:CAPEHART
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-824-6718
Mailing Address - Street 1:3600 GASTON AVE
Mailing Address - Street 2:SUITE 404
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75246-1800
Mailing Address - Country:US
Mailing Address - Phone:214-824-6718
Mailing Address - Fax:214-821-3760
Practice Address - Street 1:3600 GASTON AVE
Practice Address - Street 2:SUITE 404
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-1800
Practice Address - Country:US
Practice Address - Phone:214-824-6718
Practice Address - Fax:214-821-3760
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-02
Last Update Date:2010-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB21671Medicare UPIN