Provider Demographics
NPI:1639115140
Name:CHILDS, HAROLD K (MD)
Entity Type:Individual
Prefix:
First Name:HAROLD
Middle Name:K
Last Name:CHILDS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6901 SNIDER PLZ
Mailing Address - Street 2:SUITE 130
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75205-5648
Mailing Address - Country:US
Mailing Address - Phone:972-381-6690
Mailing Address - Fax:214-361-2552
Practice Address - Street 1:6901 SNIDER PLZ
Practice Address - Street 2:SUITE 130
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75205-5648
Practice Address - Country:US
Practice Address - Phone:972-381-6690
Practice Address - Fax:214-361-2552
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXL4884207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX157636502Medicaid
TX1639115140Medicaid
TX157636501Medicaid
TX8J3683OtherBC/BS
TX157636502Medicaid
TX8D4231Medicare PIN
TXH81924Medicare UPIN
TX157636501Medicaid