1902090236 NPI number — HARRIS CHIROPRACTIC, P.A.

Table of content: (NPI 1902090236)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902090236 NPI number — HARRIS CHIROPRACTIC, P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HARRIS CHIROPRACTIC, P.A.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1902090236
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/21/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4217 FAIRWAY BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WICHITA FALLS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76308-2454
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
940-696-5150
Provider Business Mailing Address Fax Number:
940-696-0475

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4217 FAIRWAY BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WICHITA FALLS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76308-2454
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
940-696-5150
Provider Business Practice Location Address Fax Number:
940-696-0475
Provider Enumeration Date:
08/29/2007

Additional Information

Authorized Official

Authorized Official Last Name:
HARRIS
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
W
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
940-696-5150

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  5967 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1164506986 . This is a "JAMES W. HARRIS INDIVIDUAL NPI NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 168284101 . This is a "JAMES W. HARRIS, D.C. MEDICAID NUMBER" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 0006JF . This is a "BLUE CROSS BLUE SHIELD GROUP PROVIDER NUMBER" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 1750311163 . This is a "SHEILA M. CARLEY, D.C. INDIVIDUAL NPI NUMBER" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 603728 . This is a "JAMES W. HARRIS, D.C. MEDICARE PIN" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 8G5331 . This is a "SHEILA M. CARLEY, D.C. BLUE CROSS BLUE SHIELD INDIVIDUAL PROVIDER NUMBER" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: U90943 . This is a "SHEILA M. CARLEY, D.C. UPIN" identifier . This identifiers is of the category "OTHER".
  • Identifier: U37023 . This is a "JAMES W. HARRIS, D.C. UPIN NUMBER" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 0076983 . This is a "SHEILA M. CARLEY, D.C. BLUE LINK NUMBER" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 5967 . This is a "JAMES W. HARRIS, D.C. CHIROPRACTIC STATE LICENSE NUMBER" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 609761 . This is a "SHEILA M. CARLEY,D.C. MEDICARE UPIN" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 8237023 . This is a "JAMES W. HARRIS, D.C. BLUE LINK NUMBER" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 9256 . This is a "SHEILA M. CARLEY, D.C. CHIROPRACTIC STATE LICENSE NUMBER" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 176683401 . This is a "SHEILA M.CARLEY, D.C. MEDICAID NUMBER" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 603728 . This is a "JAMES W. HARRIS, D.C. MEDICARE UPIN" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 609761 . This is a "SHEILA M. CARLEY, D.C. MEDICARE PIN" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 8G5330 . This is a "JAMES W. HARRIS, D.C. BLUE CROSS BLUE SHIELD INDIVIDUAL PROVIDER NUMBER" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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