Provider Demographics
NPI:1679281323
Name:CAPALAD, DOMINGO JR (PTA)
Entity type:Individual
Prefix:
First Name:DOMINGO
Middle Name:
Last Name:CAPALAD
Suffix:JR
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9223 ELRINGTON WOOD PL
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-6799
Mailing Address - Country:US
Mailing Address - Phone:832-646-6900
Mailing Address - Fax:
Practice Address - Street 1:9223 ELRINGTON WOOD PL
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-6799
Practice Address - Country:US
Practice Address - Phone:183-264-6690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-11
Last Update Date:2022-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2136281225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant