Provider Demographics
NPI:1366186447
Name:ELEEMOSYNANT
Entity type:Organization
Organization Name:ELEEMOSYNANT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAREL
Authorized Official - Middle Name:
Authorized Official - Last Name:CAPEK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:409-771-8516
Mailing Address - Street 1:126 POMPANO AVE
Mailing Address - Street 2:
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77550-3130
Mailing Address - Country:US
Mailing Address - Phone:409-771-8516
Mailing Address - Fax:409-220-8350
Practice Address - Street 1:107 SWIFT ST
Practice Address - Street 2:
Practice Address - City:REFUGIO
Practice Address - State:TX
Practice Address - Zip Code:78377-2425
Practice Address - Country:US
Practice Address - Phone:409-771-8516
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-25
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty