Provider Demographics
NPI:1033688734
Name:HARRIS, MONIQUE (DC)
Entity Type:Individual
Prefix:DR
First Name:MONIQUE
Middle Name:
Last Name:HARRIS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:265 E CORPORATE DR APT 436
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067-6683
Mailing Address - Country:US
Mailing Address - Phone:414-839-7122
Mailing Address - Fax:
Practice Address - Street 1:6401 W ELDORADO PKWY
Practice Address - Street 2:SUITE 301
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070
Practice Address - Country:US
Practice Address - Phone:414-839-7122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-26
Last Update Date:2018-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13969111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor