Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | H5897 | TX |
Y | 208600000X | Surgeon | H5897 | TX |
N | 2086S0129X | Vascular Surgeon | H5897 | TX |
NPI | 1033156658 |
---|---|
Provider Name | Dr. George M Hariz |
First Address | Mesquite, TX 75149-2491 |
Second Address | Mesquite, TX 75149-2476 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2006 |
Last Update Date | 19/09/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00J99Q | BLUE SHIELD (01) | TX |
020020220 | RAILROAD MEDICARE (01) | TX |
034130701 | (05) | TX |
F24710 | (02) |