1912360926 NPI number — KHALIL ANTONIO HARBIE MD

Table of content: KHALIL ANTONIO HARBIE MD (NPI 1912360926)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912360926 NPI number — KHALIL ANTONIO HARBIE MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HARBIE
Provider First Name:
KHALIL
Provider Middle Name:
ANTONIO
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1912360926
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/21/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
FRANKFORT EYE CENTER, PSC DBA BLUEGRASS EYE CARE
Provider Second Line Business Mailing Address:
100 DIAGNOSTIC DRIVE, A
Provider Business Mailing Address City Name:
FRANKFORT
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40601
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
502-875-9860
Provider Business Mailing Address Fax Number:
502-875-9887

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9157 HUEBNER RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78240-1502
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-697-2020
Provider Business Practice Location Address Fax Number:
210-558-7679
Provider Enumeration Date:
03/29/2016

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207W00000X , with the licence number:  S4964 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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