MEDICARE: HIGHLAND VILLAGE PRIMARY CARE, P.A.

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	261QP2300X	Primary Care Clinic/Center	K0859	TX

General Provider Information

NPI Number	:	1730292830
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HIGHLAND VILLAGE PRIMARY CARE, P.A.

Provider Business Mailing Address
First Line	:	2016 JUSTIN RD
Second Line	:	SUITE 370
City	:	HIGHLAND VILLAGE
State	:	TX
Zip	:	75077-7161
Country	:	US
Telephone Number	:	972-966-2525
Fax Number	:	972-966-1359

Provider Business Practice Location Address
First Line	:	2016 JUSTIN RD
Second Line	:	SUITE 370
City	:	HIGHLAND VILLAGE
State	:	TX
Zip	:	75077-7161
Country	:	US
Telephone Number	:	972-966-2525
Fax Number	:	972-966-1359

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ROMINDER KAUR
Credential	:	MD
Telephone Number	:	972-966-2525

Provider Enumeration Date	:	08/16/2006
Last Update Date	:	12/14/2007

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