Provider Demographics
NPI:1720199599
Name:BAINS, HARSHIVINDERJIT SINGH (MD)
Entity Type:Individual
Prefix:DR
First Name:HARSHIVINDERJIT
Middle Name:SINGH
Last Name:BAINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 W GRANDE BLVD
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75703-6124
Mailing Address - Country:US
Mailing Address - Phone:903-597-6444
Mailing Address - Fax:903-592-8500
Practice Address - Street 1:1201 W GRANDE BLVD
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75703-6124
Practice Address - Country:US
Practice Address - Phone:903-597-4644
Practice Address - Fax:903-592-8500
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL6277207WX0107X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
2009370570001OtherCIGNA
TX159255202Medicaid
TX167046501Medicaid
TX121127OtherCHIPS
TX0094LMOtherBLUE CROSS BLUE SHIELD
TX8P0410OtherBLUE CROSS BLUE SHIELD