Provider Demographics
NPI:1083720148
Name:HARRIS, RAYMOND SCOTT (DC)
Entity Type:Individual
Prefix:MR
First Name:RAYMOND
Middle Name:SCOTT
Last Name:HARRIS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 HARRY COURT
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:28130
Mailing Address - Country:US
Mailing Address - Phone:210-219-0981
Mailing Address - Fax:
Practice Address - Street 1:200 E RAMSEY
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216
Practice Address - Country:US
Practice Address - Phone:210-530-9000
Practice Address - Fax:210-530-9001
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDC4086111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX601507OtherBCBS
T13714Medicare UPIN