Doctor Name: | CAROL K. HARRIS |
NPI Number: | 1114095536 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | N.P. |
License Number: | 517378 |
Business Practice Address: | 413 W. Bethel Rd. #300 Coppell, TX - 75019 |
Business Phone Number: | 9723934726 |
Business Fax Number: | |
Mailing Address: | 209 Plantation Dr, COPPELL |
State: | TX |
Postal Code: | 750193233 |
Phone Number: | 9723934726 |
Fax Number: | 9723934850 |
NPI Enumeration Date: | 12/01/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 517378 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |