Provider Demographics
NPI:1982735346
Name:STEPHEN R. HARRIS, M.D. INC
Entity type:Organization
Organization Name:STEPHEN R. HARRIS, M.D. INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:R
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:915-532-3600
Mailing Address - Street 1:7300 REMCON CIR STE 200
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-1647
Mailing Address - Country:US
Mailing Address - Phone:915-532-3600
Mailing Address - Fax:915-532-8999
Practice Address - Street 1:7300 REMCON CIR STE 200
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-1647
Practice Address - Country:US
Practice Address - Phone:915-532-3600
Practice Address - Fax:915-532-8999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2016-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX171517901Medicaid
TX00C57SOtherBCBS
TX00115YMedicare ID - Type Unspecified