Provider Demographics
NPI:1750692802
Name:GEETA KHARE
Entity type:Organization
Organization Name:GEETA KHARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GEETA
Authorized Official - Middle Name:
Authorized Official - Last Name:KHARE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-262-0266
Mailing Address - Street 1:2304 OAK LN STE 5
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75051-8814
Mailing Address - Country:US
Mailing Address - Phone:972-262-0266
Mailing Address - Fax:972-262-0286
Practice Address - Street 1:2304 OAK LN STE 5
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75051-8814
Practice Address - Country:US
Practice Address - Phone:972-262-0266
Practice Address - Fax:972-262-0286
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-23
Last Update Date:2010-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1000025332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX6354460001Medicare NSC