Provider Demographics
NPI:1386620003
Name:HARLASS, FREDERICK E (MD)
Entity type:Individual
Prefix:
First Name:FREDERICK
Middle Name:E
Last Name:HARLASS
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 1:10201 GATEWAY BLVD W
Mailing Address - Street 2:STE 330
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925-7652
Mailing Address - Country:US
Mailing Address - Phone:915-593-9381
Mailing Address - Fax:915-593-6431
Practice Address - Street 1:10201 GATEWAY BLVD W
Practice Address - Street 2:STE 330
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-7652
Practice Address - Country:US
Practice Address - Phone:915-593-9381
Practice Address - Fax:915-593-6431
Is Sole Proprietor?:No
Enumeration Date:2005-12-15
Last Update Date:2007-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ0515207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8B8747Medicare ID - Type Unspecified
E98828Medicare UPIN