Harold B. Eudaly, Jr., MD, PA

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

C6960 Issued in TX

Legal business name

HAROLD B. EUDALY, JR., MD, PA

Practice address

6300 Ridglea PL
Suite 814
Fort Worth, TX 76116-5704

Phone

(817) 763-0022

Fax

(817) 763-0027

NPI assigned

Dec 12, 2008

Last updated

Dec 12, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Harold B Eudaly Jr., MD

Title

MD

Phone

(817) 763-0022

Specialties & licenses 1

Addresses

Other identifiers 3

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1229040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1229040000000",
    "number": "1639314180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6300 RIDGLEA PL",
            "address_2": "SUITE 814",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761165704",
            "telephone_number": "817-763-0022",
            "fax_number": "817-763-0027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6300 RIDGLEA PL",
            "address_2": "SUITE 814",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761165704",
            "telephone_number": "817-763-0022",
            "fax_number": "817-763-0027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAROLD B. EUDALY, JR., MD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-12",
        "last_updated": "2008-12-12",
        "status": "A",
        "authorized_official_last_name": "EUDALY",
        "authorized_official_first_name": "HAROLD",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "817-763-0022",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "C6960",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NP1",
            "identifier": "1881792026",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "204532929",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS LICENSE",
            "identifier": "C6930",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Harmony Health Fort Worth, LLC
• Harmony Health Fort Worth, LLC
• Harmony Health Transport LLC
• Harmony Primary Care Partners PLLC
• Leslie C. Harms, COTA
• Harold B.Eudaly Jr., M.D.PA
• Harold Granek Mdpa (Vitreo-Retinal Consultants of Texas)
• Harold V. Johnson, III MD PA
• Harper Interventional Pain Center LLC
• Chase Harper

• Psychiatry Physician in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Psychiatry Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.