Provider Demographics
NPI:1447380571
Name:KAREN A HARCOURT, DO PA
Entity Type:Organization
Organization Name:KAREN A HARCOURT, DO PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:A
Authorized Official - Last Name:HARCOURT
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:281-401-7943
Mailing Address - Street 1:PO BOX 204492
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75320-4492
Mailing Address - Country:US
Mailing Address - Phone:717-576-7603
Mailing Address - Fax:727-835-7122
Practice Address - Street 1:605 HOLDERRIETH BLVD
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77375-6445
Practice Address - Country:US
Practice Address - Phone:281-401-7943
Practice Address - Fax:727-835-7122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-07
Last Update Date:2015-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP7117207Q00000X, 2083P0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No2083P0011XAllopathic & Osteopathic PhysiciansPreventive MedicineUndersea and Hyperbaric MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX328373101Medicaid
TX328373101Medicaid