Provider Demographics
NPI:1811131808
Name:KHARE, GEETA
Entity type:Individual
Prefix:
First Name:GEETA
Middle Name:
Last Name:KHARE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2304 OAK LANE
Mailing Address - Street 2:STE # 5
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75051
Mailing Address - Country:US
Mailing Address - Phone:972-262-0266
Mailing Address - Fax:972-262-0286
Practice Address - Street 1:2304 OAK LN
Practice Address - Street 2:STE # 5
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75051-8812
Practice Address - Country:US
Practice Address - Phone:972-262-0266
Practice Address - Fax:972-262-0286
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-22
Last Update Date:2010-06-22
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