Provider Demographics
NPI:1033152871
Name:LOTAY, HARPREET KAUR (MD)
Entity Type:Individual
Prefix:
First Name:HARPREET
Middle Name:KAUR
Last Name:LOTAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:712 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78006-2437
Mailing Address - Country:US
Mailing Address - Phone:830-249-9604
Mailing Address - Fax:
Practice Address - Street 1:712 RIVER RD
Practice Address - Street 2:
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78006-2437
Practice Address - Country:US
Practice Address - Phone:830-249-9604
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL7018207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0001MBOtherBCBS PROVIDER NUMBER
TXL7018OtherLICENSE
TXL7018OtherLICENSE
G24962Medicare UPIN