Provider Demographics
NPI:1346210226
Name:GILES, HARLAN R (MD)
Entity Type:Individual
Prefix:MR
First Name:HARLAN
Middle Name:R
Last Name:GILES
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 1:10201 GATEWAY BLVD W STE 300
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925-7647
Mailing Address - Country:US
Mailing Address - Phone:915-599-8887
Mailing Address - Fax:915-599-8965
Practice Address - Street 1:10201 GATEWAY BLVD W STE 300
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-7647
Practice Address - Country:US
Practice Address - Phone:915-599-8887
Practice Address - Fax:915-599-8965
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-24
Last Update Date:2020-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF5211207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000070791OtherUNISON HEALTH PLAN
PA481494OtherHIGHMARK BLUE SHIELD
PA0010711140003Medicaid
1542658OtherGATEWAY HEALTH PLAN
TX043063903Medicaid
PA220660OtherHEALTH AMERICA
PA203184OtherUPMC HEALTH PLAN
476280OtherAETNA US HEALTHCARE
000000070791OtherUNISON HEALTH PLAN