Provider Demographics
NPI:1902106149
Name:HARWIN MEDICAL GROUP, INC
Entity Type:Organization
Organization Name:HARWIN MEDICAL GROUP, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:FASULLO
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:713-541-1300
Mailing Address - Street 1:10333 HARWIN DR
Mailing Address - Street 2:SUITE 540
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-1545
Mailing Address - Country:US
Mailing Address - Phone:713-541-1300
Mailing Address - Fax:
Practice Address - Street 1:10333 HARWIN DR
Practice Address - Street 2:SUITE 540
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-1545
Practice Address - Country:US
Practice Address - Phone:713-541-1300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-21
Last Update Date:2010-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty