Provider Demographics
NPI:1730292830
Name:HIGHLAND VILLAGE PRIMARY CARE, P.A.
Entity Type:Organization
Organization Name:HIGHLAND VILLAGE PRIMARY CARE, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROMINDER
Authorized Official - Middle Name:
Authorized Official - Last Name:KAUR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-966-2525
Mailing Address - Street 1:2016 JUSTIN RD
Mailing Address - Street 2:SUITE 370
Mailing Address - City:HIGHLAND VILLAGE
Mailing Address - State:TX
Mailing Address - Zip Code:75077-7161
Mailing Address - Country:US
Mailing Address - Phone:972-966-2525
Mailing Address - Fax:972-966-1359
Practice Address - Street 1:2016 JUSTIN RD
Practice Address - Street 2:SUITE 370
Practice Address - City:HIGHLAND VILLAGE
Practice Address - State:TX
Practice Address - Zip Code:75077-7161
Practice Address - Country:US
Practice Address - Phone:972-966-2525
Practice Address - Fax:972-966-1359
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-16
Last Update Date:2007-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK0859261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00926TMedicare PIN
TXH67581Medicare UPIN
TXG42249Medicare UPIN