Provider Demographics
NPI:1013418466
Name:HARRIS, LINDA
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:
Last Name:HARRIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1798 STRICKLAND LN
Mailing Address - Street 2:
Mailing Address - City:EAGLE LAKE
Mailing Address - State:TX
Mailing Address - Zip Code:77434-7082
Mailing Address - Country:US
Mailing Address - Phone:979-243-4229
Mailing Address - Fax:
Practice Address - Street 1:1776 STRICKLAND LN
Practice Address - Street 2:
Practice Address - City:EAGLE LAKE
Practice Address - State:TX
Practice Address - Zip Code:77434-7082
Practice Address - Country:US
Practice Address - Phone:979-243-4229
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-21
Last Update Date:2018-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Single Specialty