Provider Demographics
NPI:1164605309
Name:EDWARD G OORJITHAM MD PA
Entity Type:Organization
Organization Name:EDWARD G OORJITHAM MD PA
Other - Org Name:HARLINGEN FAMILY PRACTICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:G
Authorized Official - Last Name:OORJITHAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-440-8020
Mailing Address - Street 1:1205 N ED CAREY DR
Mailing Address - Street 2:ST 2C
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-9207
Mailing Address - Country:US
Mailing Address - Phone:956-440-8020
Mailing Address - Fax:956-440-8131
Practice Address - Street 1:1205 N ED CAREY DR
Practice Address - Street 2:ST 2C
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-9207
Practice Address - Country:US
Practice Address - Phone:956-440-8020
Practice Address - Fax:956-440-8131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-11
Last Update Date:2007-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ5113207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0018DFOtherBC/BS
TX0018DFOtherBC/BS
TX00766DMedicare PIN