Provider Demographics
NPI:1932165651
Name:HARIYANI, GULABDAS D (MD)
Entity Type:Individual
Prefix:
First Name:GULABDAS
Middle Name:D
Last Name:HARIYANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6380 MORGAN AVE
Mailing Address - Street 2:SUITE E
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79906
Mailing Address - Country:US
Mailing Address - Phone:916-801-7638
Mailing Address - Fax:915-568-4380
Practice Address - Street 1:6380 MORGAN AVE
Practice Address - Street 2:SUITE E
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79906
Practice Address - Country:US
Practice Address - Phone:915-568-3505
Practice Address - Fax:915-568-4380
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-21
Last Update Date:2011-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036069248208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice