Provider Demographics
NPI: | 1902090236 |
---|---|
Name: | HARRIS CHIROPRACTIC, P.A. |
Entity type: | Organization |
Organization Name: | HARRIS CHIROPRACTIC, P.A. |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | PRESIDENT |
Authorized Official - Prefix: | |
Authorized Official - First Name: | JAMES |
Authorized Official - Middle Name: | W |
Authorized Official - Last Name: | HARRIS |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | DC |
Authorized Official - Phone: | 940-696-5150 |
Mailing Address - Street 1: | 4217 FAIRWAY BLVD |
Mailing Address - Street 2: | |
Mailing Address - City: | WICHITA FALLS |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 76308-2454 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 940-696-5150 |
Mailing Address - Fax: | 940-696-0475 |
Practice Address - Street 1: | 4217 FAIRWAY BLVD |
Practice Address - Street 2: | |
Practice Address - City: | WICHITA FALLS |
Practice Address - State: | TX |
Practice Address - Zip Code: | 76308-2454 |
Practice Address - Country: | US |
Practice Address - Phone: | 940-696-5150 |
Practice Address - Fax: | 940-696-0475 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2007-08-29 |
Last Update Date: | 2009-01-21 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
TX | 5967 | 111N00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 111N00000X | Chiropractic Providers | Chiropractor | Group - Single Specialty |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
1164506986 | Other | JAMES W. HARRIS INDIVIDUAL NPI NUMBER | |
TX | 168284101 | Other | JAMES W. HARRIS, D.C. MEDICAID NUMBER |
TX | 0006JF | Other | BLUE CROSS BLUE SHIELD GROUP PROVIDER NUMBER |
TX | 1750311163 | Other | SHEILA M. CARLEY, D.C. INDIVIDUAL NPI NUMBER |
TX | 603728 | Other | JAMES W. HARRIS, D.C. MEDICARE PIN |
TX | 8G5331 | Other | SHEILA M. CARLEY, D.C. BLUE CROSS BLUE SHIELD INDIVIDUAL PROVIDER NUMBER |
U90943 | Other | SHEILA M. CARLEY, D.C. UPIN | |
TX | U37023 | Other | JAMES W. HARRIS, D.C. UPIN NUMBER |
TX | 0076983 | Other | SHEILA M. CARLEY, D.C. BLUE LINK NUMBER |
TX | 5967 | Other | JAMES W. HARRIS, D.C. CHIROPRACTIC STATE LICENSE NUMBER |
TX | 609761 | Other | SHEILA M. CARLEY,D.C. MEDICARE UPIN |
TX | 8237023 | Other | JAMES W. HARRIS, D.C. BLUE LINK NUMBER |
TX | 9256 | Other | SHEILA M. CARLEY, D.C. CHIROPRACTIC STATE LICENSE NUMBER |
TX | 176683401 | Other | SHEILA M.CARLEY, D.C. MEDICAID NUMBER |
TX | 603728 | Other | JAMES W. HARRIS, D.C. MEDICARE UPIN |
TX | 609761 | Other | SHEILA M. CARLEY, D.C. MEDICARE PIN |
TX | 8G5330 | Other | JAMES W. HARRIS, D.C. BLUE CROSS BLUE SHIELD INDIVIDUAL PROVIDER NUMBER |