# I-35 CAPITAL PHYSICIANS GROUP, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275025298
- **Authorized official:** CRYSTAL MATA (VP OF OPERATIONS)
- **Authorized official phone:** (469) 556-7186

## Contact information

- **Practice address:** 220 N RIDGEWAY DR, CLEBURNE, TX 76033-4115
- **Practice address phone:** (817) 556-4800
- **Mailing address:** 550 BAILEY AVE STE 360, FT WORTH, TX 76107-2100
- **Mailing address phone:** (817) 779-4244
- **Mailing address fax:** (817) 779-4429

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/05/2018
- **Last updated:** 06/05/2018