Provider Demographics
NPI:1447784913
Name:HARIRI, OMAR KAREEM (MD)
Entity Type:Individual
Prefix:
First Name:OMAR
Middle Name:KAREEM
Last Name:HARIRI
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 1:222 S COLLINS RD STE 101
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:TX
Mailing Address - Zip Code:75182-4645
Mailing Address - Country:US
Mailing Address - Phone:214-256-3778
Mailing Address - Fax:214-256-3770
Practice Address - Street 1:222 S COLLINS RD STE 101
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:TX
Practice Address - Zip Code:75182-4645
Practice Address - Country:US
Practice Address - Phone:214-256-3778
Practice Address - Fax:214-256-3770
Is Sole Proprietor?:No
Enumeration Date:2017-04-12
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA174910207X00000X
390200000X
TXU2504207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program