Provider Demographics
NPI:1720439771
Name:HARRIS, MORGAN LACY (DC)
Entity type:Individual
Prefix:DR
First Name:MORGAN
Middle Name:LACY
Last Name:HARRIS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1344 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02451-1617
Mailing Address - Country:US
Mailing Address - Phone:903-316-7762
Mailing Address - Fax:
Practice Address - Street 1:223 DWIRE DR
Practice Address - Street 2:
Practice Address - City:LA PORTE
Practice Address - State:TX
Practice Address - Zip Code:77571-7029
Practice Address - Country:US
Practice Address - Phone:903-316-7762
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-30
Last Update Date:2016-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13206111N00000X
MA3531111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor