Provider Demographics
NPI:1568694628
Name:RAYMOND P. HARLE, M.D., P.A.
Entity Type:Organization
Organization Name:RAYMOND P. HARLE, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:HARLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-614-3866
Mailing Address - Street 1:8042 WURZBACH RD
Mailing Address - Street 2:SUITE 240
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3818
Mailing Address - Country:US
Mailing Address - Phone:210-614-3866
Mailing Address - Fax:210-614-3837
Practice Address - Street 1:8042 WURZBACH RD
Practice Address - Street 2:SUITE 240
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3818
Practice Address - Country:US
Practice Address - Phone:210-614-3866
Practice Address - Fax:210-614-3837
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-21
Last Update Date:2009-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXC5705207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
003103Medicare PIN
C 16603Medicare UPIN