Individual
S ROBERT HARLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
160 CREEKSIDE PARK RD, STE 300, SPRING BRANCH, TX 78070-6150
(512) 451-0139
(512) 323-5880
Mailing address
3500 JEFFERSON ST, STE 200, AUSTIN, TX 78731-6200
(512) 451-0139
(512) 323-5880
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
J2053
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
133607508
—
TX
01
—
8AJ669
BCBS SOLO NUMBER
TX
01
—
8FC810
BCBS PV#
TX
01
—
P00998010
RAILROAD MEDICARE
TX
Enumeration date
01/24/2006
Last updated
01/31/2017
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