Provider Demographics
NPI:1124085774
Name:HARATI, ARUNDHATI (MD)
Entity type:Individual
Prefix:
First Name:ARUNDHATI
Middle Name:
Last Name:HARATI
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 1:400 W ARBROOK BLVD STE 240
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76014-3177
Mailing Address - Country:US
Mailing Address - Phone:817-467-0240
Mailing Address - Fax:817-472-9385
Practice Address - Street 1:400 W ARBROOK BLVD STE 240
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76014-3177
Practice Address - Country:US
Practice Address - Phone:817-467-0240
Practice Address - Fax:817-472-9385
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2013-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL7409207R00000X
NM20020232207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX155530201Medicaid
H61590Medicare UPIN
TX8B1155Medicare PIN