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MARIO OSVALDO KAPUSTA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
5585 WESLAYAN ST, HOUSTON, TX 77005-1941
(713) 349-8346
(713) 218-8346
Mailing address
PO BOX 6730, HOUSTON, TX 77265-6730
(713) 349-8346
(713) 218-8346

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
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