Provider Demographics
NPI:1205939337
Name:MUNISWAMY, HARISH (MD)
Entity type:Individual
Prefix:
First Name:HARISH
Middle Name:
Last Name:MUNISWAMY
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 1:6100 HARRIS PKWY
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76132-4101
Mailing Address - Country:US
Mailing Address - Phone:817-250-4906
Mailing Address - Fax:817-250-4815
Practice Address - Street 1:6100 HARRIS PKWY
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76132-4101
Practice Address - Country:US
Practice Address - Phone:817-250-4906
Practice Address - Fax:817-250-4815
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2018-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN41628207R00000X
NY002639207R00000X
TXN0300207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN610916101OtherDEPT. OF LABOR
TN203768OtherBETTER HEALTH PLANS OF TN
TN39215OtherTLC
TN4139145OtherBCBS
TN610916101OtherCIGNA
TNTN104OtherAMERICHOICE
TN3827578Medicaid
TNTN00004OtherAMERICHOICE
TN3827578Medicare PIN
TNTN00004OtherAMERICHOICE
TNI66748Medicare UPIN