Provider Demographics
NPI:1003864158
Name:HARDING, ROBERT LEE JR (DO)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:LEE
Last Name:HARDING
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:712 MERIDEN LN # B
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78703-4524
Mailing Address - Country:US
Mailing Address - Phone:512-351-8308
Mailing Address - Fax:
Practice Address - Street 1:3201 S WATER ST
Practice Address - Street 2:
Practice Address - City:BURNET
Practice Address - State:TX
Practice Address - Zip Code:78611-4510
Practice Address - Country:US
Practice Address - Phone:512-715-3010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-04
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS013329207PE0004X
TXM3573207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX181159810Medicaid
TX8AB497OtherBCBS
TX181159804Medicaid
TX8K8347OtherBCBS
TX181159805Medicaid
TX181159807Medicaid
TX8X7454OtherBCBS
TX8AS822OtherBCBS
TX8V5760OtherBCBS
TX8S1816OtherBCBS
TX8G7729Medicare PIN
TX8G7728Medicare PIN
TX8K8347OtherBCBS
TX8AB497OtherBCBS
TX8X7454OtherBCBS
TX181159807Medicaid
TX8AS822OtherBCBS
TX8V5760OtherBCBS
TX8K2781Medicare PIN