Provider Demographics
NPI:1679962583
Name:HARISH MUNISWAMY MD PA
Entity Type:Organization
Organization Name:HARISH MUNISWAMY MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:HARISH
Authorized Official - Middle Name:
Authorized Official - Last Name:MUNISWAMY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:646-894-0807
Mailing Address - Street 1:762 CHALAIS CT
Mailing Address - Street 2:
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-4589
Mailing Address - Country:US
Mailing Address - Phone:646-894-0807
Mailing Address - Fax:
Practice Address - Street 1:762 CHALAIS CT
Practice Address - Street 2:
Practice Address - City:COPPELL
Practice Address - State:TX
Practice Address - Zip Code:75019-4589
Practice Address - Country:US
Practice Address - Phone:646-894-0807
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-15
Last Update Date:2015-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN0300261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXN0300OtherLICENSE