Provider Demographics
NPI:1114276946
Name:HARRIS, EVA C
Entity Type:Individual
Prefix:MISS
First Name:EVA
Middle Name:C
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 1:2011 KNOLL OAK LN
Mailing Address - Street 2:
Mailing Address - City:ROSENBERG
Mailing Address - State:TX
Mailing Address - Zip Code:77469-5732
Mailing Address - Country:US
Mailing Address - Phone:281-818-4780
Mailing Address - Fax:281-408-4169
Practice Address - Street 1:4800 SUGAR GROVE BLVD STE 308
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-2639
Practice Address - Country:US
Practice Address - Phone:281-818-4780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-07
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX14619826424Medicaid