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Organization

HARSHI BAINS MDPA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. HARSHIVINDERJIT SINGH BAINS MD (PRESIDENT)
(903) 597-4644
Entity
Organization

Contact information

Practice address
1201 W GRANDE BLVD, TYLER, TX 75703-6124
(903) 597-4644
(903) 592-8500
Mailing address
1201 W GRANDE BLVD, TYLER, TX 75703-6124
(903) 597-4644
(903) 592-8500

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
207WX0107X
Retina Specialist (Ophthalmology) Physician
L6277
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00949W
MEDICARE ID
TX
01
0094LM
BLUE CROSS BLUE SHIELD
05
1275644049
TX
05
159255202
TX
05
167046501
TX
01
8P0410
BCBS OF TEXAS
TX
Enumeration date
08/31/2006
Last updated
09/15/2023
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