Healthcare Provider Details

I. General information

NPI: 1346082864
Provider Name (Legal Business Name): LIOR HAR SHAI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2024
Last Update Date: 12/09/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UT SOUTHWESTERN MEDICAL CENTER, DEPARTMENT OF PLASTIC S 1801 INWOOD ROAD
DALLAS TX
75390-9132
US

IV. Provider business mailing address

KIBBUTZ MISHMAR HASHARON
MISHMAR HASHARON ISRAEL
4027000
IL

V. Phone/Fax

Practice location:
  • Phone: 214-645-3104
  • Fax: 214-645-3148
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: