Provider Demographics
NPI:1285768739
Name:KAP GERI DOK PLLC
Entity type:Organization
Organization Name:KAP GERI DOK PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KOJO
Authorized Official - Middle Name:A
Authorized Official - Last Name:POBEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:469-323-8556
Mailing Address - Street 1:5440 HARVEST HILL RD STE 200
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-6415
Mailing Address - Country:US
Mailing Address - Phone:214-348-7611
Mailing Address - Fax:214-348-0129
Practice Address - Street 1:4514 COLE AVE
Practice Address - Street 2:SUITE 610
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75205-5412
Practice Address - Country:US
Practice Address - Phone:214-559-7135
Practice Address - Fax:214-705-3803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK7592207RG0300X
TX647333363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Multi-Specialty
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0083PLOtherBCBS
TX186550302Medicaid
TX186550302Medicaid