Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | S9326 | TX |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | S9326 | TX |
NPI | 1124413976 |
---|---|
Provider Name | Jason Edward Kappa |
First Address | Pearland, TX 77584-7298 |
Second Address | Houston, TX 77025-1669 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2015 |
Last Update Date | 28/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
428115601 | (05) | TX |
428115603 | (05) | TX |