Basic Information
| Provider Information | |||||||||
| NPI: | 1871214726 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | HARDY | ||||||||
| FirstName: | GHISLAIN | ||||||||
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| Credential: | M.D | ||||||||
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| Mailing Information | |||||||||
| Address1: | 440 RAYNOLDS ST # 51015 | ||||||||
| Address2: | |||||||||
| City: | EL PASO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 799051613 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9152154480 | ||||||||
| FaxNumber: | 9152155386 | ||||||||
| Practice Location | |||||||||
| Address1: | 4801 ALBERTA AVE | ||||||||
| Address2: | |||||||||
| City: | EL PASO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 799052707 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9152155000 | ||||||||
| FaxNumber: | 9152158662 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/08/2022 | ||||||||
| LastUpdateDate: | 10/25/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 10/25/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 47783 | TX | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 207VM0101X | 47783 | TX | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Maternal & Fetal Medicine |
No ID Information.