Provider Demographics
NPI:1528075892
Name:HARRIS, STEPHEN A (DC)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:A
Last Name:HARRIS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:167 CITADEL WAY
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-7147
Mailing Address - Country:US
Mailing Address - Phone:281-980-1050
Mailing Address - Fax:281-980-1348
Practice Address - Street 1:167 CITADEL WAY
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-7147
Practice Address - Country:US
Practice Address - Phone:281-980-1050
Practice Address - Fax:281-980-1348
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDC2438111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX600780OtherBCBS
TX600780OtherBCBS
TX600780Medicare PIN