Organization
KAPUSTA COSMETIC AND MEDICAL VEIN CENTER, P.A.
Active
Other names
Vein Center Houston
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARIO OSVALDO KAPUSTA M.D. (PRESIDENT)
(713) 349-8346
Entity
Organization
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
Primary
F0537
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0087KZ
BCBS GROUP
TX
Enumeration date
12/26/2007
Last updated
12/26/2007
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