Individual
MARIO OSVALDO KAPUSTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
11435
OK
174400000X
Specialist
C42419
CA
174400000X
Specialist
F0537
TX
2086S0129X
Vascular Surgery Physician
Primary
F0537
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060049733
RAILROAD MEDICARE
TX
05
—
134953204
—
TX
01
—
4076907
AETNA
TX
01
—
8M0430
BLUE CROSS BLUE SHEILD
TX
05
—
P082460J2
—
TX
Enumeration date
08/29/2006
Last updated
03/07/2022
Update your record
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