Provider Demographics
NPI:1063971612
Name:HARRIS, ERIK JASON (LVN)
Entity type:Individual
Prefix:MR
First Name:ERIK
Middle Name:JASON
Last Name:HARRIS
Suffix:
Gender:M
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5311 VISTA COURT DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78247-4673
Mailing Address - Country:US
Mailing Address - Phone:210-994-1192
Mailing Address - Fax:
Practice Address - Street 1:400 N LOOP 1604 E STE 350
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-1289
Practice Address - Country:US
Practice Address - Phone:210-255-1466
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-13
Last Update Date:2019-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX342338164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse