Provider Demographics
NPI:1609225226
Name:VIN, HARINA PRAKASH (MD)
Entity Type:Individual
Prefix:DR
First Name:HARINA
Middle Name:PRAKASH
Last Name:VIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:HARINA
Other - Middle Name:
Other - Last Name:VIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:413 W BETHEL RD STE 100
Mailing Address - Street 2:
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-4474
Mailing Address - Country:US
Mailing Address - Phone:469-312-7302
Mailing Address - Fax:
Practice Address - Street 1:413 W BETHEL RD STE 100
Practice Address - Street 2:
Practice Address - City:COPPELL
Practice Address - State:TX
Practice Address - Zip Code:75019-4474
Practice Address - Country:US
Practice Address - Phone:469-312-7302
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-04
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS5288207N00000X, 207N00000X
TXBP10059125390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program