Provider Demographics
NPI:1356512834
Name:HARPREET K. LOTAY, MD PA
Entity type:Organization
Organization Name:HARPREET K. LOTAY, MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HARPREET
Authorized Official - Middle Name:KAUR
Authorized Official - Last Name:LOTAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:830-248-1205
Mailing Address - Street 1:712 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78006-2437
Mailing Address - Country:US
Mailing Address - Phone:830-248-1205
Mailing Address - Fax:
Practice Address - Street 1:712 RIVER RD
Practice Address - Street 2:
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78006-2437
Practice Address - Country:US
Practice Address - Phone:830-248-1205
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-12
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL7018207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00992XMedicare PIN