Provider Demographics
NPI:1700804499
Name:HARLIN, BADIA ISLAH (NP C)
Entity Type:Individual
Prefix:
First Name:BADIA
Middle Name:ISLAH
Last Name:HARLIN
Suffix:
Gender:F
Credentials:NP C
Other - Prefix:
Other - First Name:BADIA
Other - Middle Name:ISLAH
Other - Last Name:ABDULLAH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP C
Mailing Address - Street 1:5801 OAKBEND TRL STE 200
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76132-3916
Mailing Address - Country:US
Mailing Address - Phone:817-529-9100
Mailing Address - Fax:817-529-9106
Practice Address - Street 1:6839 COMMUNICATIONS PKWY
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-5991
Practice Address - Country:US
Practice Address - Phone:972-733-7242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF0306136363LG0600X
TXAP114748363LP2300X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX189380203Medicaid
TXDQ5280OtherMEDICARE RR PALMETTO
TXD07564OtherMEDICARE RR PALMETTO
TX189380202Medicaid
TX189380203Medicaid
TX8K5919Medicare PIN
TXD07564OtherMEDICARE RR PALMETTO
TX275632YKPWMedicare PIN
TX189380202Medicaid