Provider Demographics
NPI:1275644049
Name:HARSHI BAINS MDPA
Entity Type:Organization
Organization Name:HARSHI BAINS MDPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HARSHIVINDERJIT
Authorized Official - Middle Name:SINGH
Authorized Official - Last Name:BAINS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:903-597-4644
Mailing Address - Street 1:1201 W GRANDE BLVD
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75703-6124
Mailing Address - Country:US
Mailing Address - Phone:903-597-4644
Mailing Address - Fax:903-592-8500
Practice Address - Street 1:1201 W GRANDE BLVD
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75703-6124
Practice Address - Country:US
Practice Address - Phone:903-597-4644
Practice Address - Fax:903-592-8500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207W00000X
TXL6277207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
No207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina SpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX167046501Medicaid
TX8P0410OtherBCBS OF TEXAS
TX159255202Medicaid
0094LMOtherBLUE CROSS BLUE SHIELD
TX1275644049Medicaid
TX00949WOtherMEDICARE ID
TX00949WMedicare PIN