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Organization

HARISH KOOLWAL MD PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. HARISH KOOLWAL MD (PHYSICIAN)
(956) 994-1177
Entity
Organization

Contact information

Practice address
214 W SAM HOUSTON BLVD, SUITE A, PHARR, TX 78577-5346
(956) 994-1177
(956) 283-0647
Mailing address
214 W SAM HOUSTON BLVD, SUITE A, PHARR, TX 78577-5346
(956) 994-1177
(956) 283-0647

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
H77771
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00689R
BLUE CROSS GROUP
TX
05
145516401
TX
Enumeration date
01/18/2007
Last updated
01/09/2012
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