Provider Demographics
NPI:1093794109
Name:HARO, LUIS H (MD)
Entity Type:Individual
Prefix:
First Name:LUIS
Middle Name:H
Last Name:HARO
Suffix:
Gender:M
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:PO BOX 841656
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-1656
Mailing Address - Country:US
Mailing Address - Phone:903-531-5000
Mailing Address - Fax:
Practice Address - Street 1:800 E DAWSON ST
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-2036
Practice Address - Country:US
Practice Address - Phone:903-531-4262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-17
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN43166207PE0004X
TXN2105207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX75-2616977-002OtherTRICARE
TXP01255063OtherRAIL ROAD
TX200179401Medicaid
TX200179402Medicaid
TX750818167048OtherTRICARE
TX8DU755OtherBCBS
TXP00718738OtherRAIL ROAD
TX200179404Medicaid
TX75-0818167-022OtherTRICARE
TX751976930005OtherTRICARE
TXP00792068OtherRAIL ROAD
TX200179403Medicaid
TX8DU754OtherBCBS
TX750818167-044OtherTRICARE
TX750818167015OtherTRICARE
TX75-2616977-001OtherTRICARE
TX75-2616977-028OtherTRICARE
TX315946YNSXMedicare PIN
TX751976930005OtherTRICARE
TX75-2616977-028OtherTRICARE
TX750818167015OtherTRICARE
TX8L8724Medicare Oscar/Certification