Provider Demographics
NPI:1376501528
Name:HARAWAY, ERIN (MD)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:HARAWAY
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 1:900 E 30TH ST
Mailing Address - Street 2:STE 109
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-3323
Mailing Address - Country:US
Mailing Address - Phone:512-368-4010
Mailing Address - Fax:
Practice Address - Street 1:900 E 30TH ST
Practice Address - Street 2:SUITE 109
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-3326
Practice Address - Country:US
Practice Address - Phone:512-544-8145
Practice Address - Fax:512-544-8146
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2020-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL9724207P00000X, 207PE0004X, 2083P0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0011XAllopathic & Osteopathic PhysiciansPreventive MedicineUndersea and Hyperbaric Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX173353702Medicaid
TX173353702Medicaid
TX8D5782Medicare ID - Type Unspecified