Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | M3573 | TX |
N | 207PE0004X | Emergency Medical Services | OS013329 | PA |
NPI | 1003864158 |
---|---|
Provider Name | Robert Lee Harding JR. |
First Address | Austin, TX 78703-4524 |
Second Address | Burnet, TX 78611-4510 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2006 |
Last Update Date | 10/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
181159804 | (05) | TX |
181159805 | (05) | TX |
181159807 | (05) | TX |
181159810 | (05) | TX |
8AB497 | BCBS (01) | TX |
8AS822 | BCBS (01) | TX |
8K8347 | BCBS (01) | TX |
8S1816 | BCBS (01) | TX |
8V5760 | BCBS (01) | TX |
8X7454 | BCBS (01) | TX |
I58801 | (02) | TX |