Individual
DR. JEFFREY DAVID DECAPRIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
K0284
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0035MH
BLUE CROSS/BLUE SHIELD
TX
01
—
03080021800
QUALCHOICE QCA OF AR
TX
05
—
149598001
—
AR
05
—
157600102
—
TX
05
—
157600103
—
TX
01
—
82411
GROUP 8-P149
AR
Enumeration date
06/17/2005
Last updated
09/07/2023
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