Provider Demographics
NPI:1437217536
Name:HARTMAN, ISRAEL A (MD)
Entity Type:Individual
Prefix:DR
First Name:ISRAEL
Middle Name:A
Last Name:HARTMAN
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 1:501 RITA LN STE 113
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76014-2010
Mailing Address - Country:US
Mailing Address - Phone:817-468-9200
Mailing Address - Fax:817-468-9358
Practice Address - Street 1:501 RITA LN STE 113
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76014-2010
Practice Address - Country:US
Practice Address - Phone:817-468-9200
Practice Address - Fax:817-468-9358
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ6997174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX752729598OtherTAX IDENTIFICATION NUMBER
TX135333610Medicaid
TX135333610Medicaid
TXF32962Medicare UPIN