Provider Demographics
NPI:1215987326
Name:MEDA, HARININEERAJA (MD,)
Entity type:Individual
Prefix:DR
First Name:HARININEERAJA
Middle Name:
Last Name:MEDA
Suffix:
Gender:
Credentials:MD,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4508 LEGACY DR STE 400
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-2189
Mailing Address - Country:US
Mailing Address - Phone:214-778-2390
Mailing Address - Fax:214-778-2396
Practice Address - Street 1:4508 LEGACY DR
Practice Address - Street 2:STE 400
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-2188
Practice Address - Country:US
Practice Address - Phone:214-778-2390
Practice Address - Fax:214-778-2394
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-11
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM2710207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH0143047OtherDPS
TXM2710OtherSTATE LICENSE
TX8BG040OtherBCBS
TXH0143047OtherDPS
TXBM 9435909OtherDEA
TXM2710OtherSTATE LICENSE