Provider Demographics
NPI:1164532479
Name:HARRIS, SCOTT W (MD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:W
Last Name:HARRIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6020 W PLANO PKWY
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-4640
Mailing Address - Country:US
Mailing Address - Phone:972-543-2477
Mailing Address - Fax:
Practice Address - Street 1:6020 W PLANO PKWY
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-4640
Practice Address - Country:US
Practice Address - Phone:972-543-2477
Practice Address - Fax:972-543-2499
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG7767208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX135545509Medicaid
TX240007846OtherRAILROAD
TX8F8561OtherBCBS
TX8699B0Medicare PIN
TX8F8561OtherBCBS