Individual
C MARK CAPISTRANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3201 UNIVERSITY DR E, SUITE 250, BRYAN, TX 77802-3475
(979) 731-8558
(979) 731-8654
Mailing address
3201 UNIVERSITY DR E, SUITE 250, BRYAN, TX 77802-3475
(979) 731-8558
(979) 731-8654
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
J8943
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8V4920
BLUE CROSS BLUE SHIELD
TX
Enumeration date
11/06/2006
Last updated
07/08/2007
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