Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | M9905 | TX |
NPI | 1063695328 |
---|---|
Provider Name | Owen Capocyan |
First Address | Sugar Land, TX 77479-5320 |
Second Address | Sugar Land, TX 77479-5320 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/12/2007 |
Last Update Date | 07/06/2019 |