Provider Demographics
NPI:1396794202
Name:WALIA, HARJEET ROSIE (MD)
Entity type:Individual
Prefix:
First Name:HARJEET
Middle Name:ROSIE
Last Name:WALIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 COIT RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-7756
Mailing Address - Country:US
Mailing Address - Phone:972-985-8393
Mailing Address - Fax:972-964-7707
Practice Address - Street 1:1200 COIT RD
Practice Address - Street 2:SUITE 105
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-7756
Practice Address - Country:US
Practice Address - Phone:972-985-8393
Practice Address - Fax:972-964-7707
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-08
Last Update Date:2010-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG2879207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXC23061Medicare UPIN