Provider Demographics
NPI:1851571640
Name:HARRIS, SABRINA DENISE (MD)
Entity type:Individual
Prefix:MISS
First Name:SABRINA
Middle Name:DENISE
Last Name:HARRIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:SABRINA
Other - Middle Name:DENISE
Other - Last Name:HARRIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:34 GRIGGS PT
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78254-2542
Mailing Address - Country:US
Mailing Address - Phone:210-464-4950
Mailing Address - Fax:
Practice Address - Street 1:34 GRIGGS PT
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78254-2542
Practice Address - Country:US
Practice Address - Phone:210-464-4950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-08
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ2057207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXF80884Medicare UPIN