Provider Demographics
NPI:1154832418
Name:HARBISON, PAUL EVAN (FNP)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:EVAN
Last Name:HARBISON
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:381 S LOOP 336 W STE 900
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-3351
Mailing Address - Country:US
Mailing Address - Phone:936-703-1827
Mailing Address - Fax:833-749-0332
Practice Address - Street 1:381 S LOOP 336 W STE 900
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-3351
Practice Address - Country:US
Practice Address - Phone:936-703-1827
Practice Address - Fax:833-749-0332
Is Sole Proprietor?:No
Enumeration Date:2017-10-13
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP135454363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily