MEDICARE: HSR MEDICAL PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician

General Provider Information

NPI Number	:	1093468225
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HSR MEDICAL PLLC

Provider Business Mailing Address
First Line	:	402 CAPE HATTERAS DR
Second Line	:
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78412-2666
Country	:	US
Telephone Number	:	361-236-5446
Fax Number	:

Provider Business Practice Location Address
First Line	:	2838 SPID DR
Second Line	:
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78415-1810
Country	:	US
Telephone Number	:	361-236-5446
Fax Number	:

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	ROBERT S HARBOLOVIC
Credential	:	MD
Telephone Number	:	361-236-5446

Provider Enumeration Date	:	01/28/2022
Last Update Date	:	02/11/2022

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