Provider Demographics
NPI:1518087576
Name:KUMAR, HARESH (MD)
Entity Type:Individual
Prefix:
First Name:HARESH
Middle Name:
Last Name:KUMAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2710 HOSPITAL DRIVE
Mailing Address - Street 2:SUITE 114
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77901-5701
Mailing Address - Country:US
Mailing Address - Phone:361-582-7999
Mailing Address - Fax:361-582-7998
Practice Address - Street 1:2710 HOSPITAL DRIVE
Practice Address - Street 2:SUITE 114
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77901-5701
Practice Address - Country:US
Practice Address - Phone:361-582-7999
Practice Address - Fax:361-582-7998
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-30
Last Update Date:2015-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN1373207RN0300X, 207RN0300X
OH35.093211207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX218061401Medicaid
TXTXB137055Medicare PIN
TXTXB114420Medicare PIN
KY00379004Medicare PIN
KY7100091900Medicaid