Provider Demographics
NPI:1174821573
Name:HARRIS, JULIE ANN (RPH)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ANN
Last Name:HARRIS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MRS
Other - First Name:JULIE
Other - Middle Name:ANN
Other - Last Name:ABERNATHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:4750 BAILEY BOSWELL RD.
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76179
Mailing Address - Country:US
Mailing Address - Phone:682-316-7508
Mailing Address - Fax:682-316-7511
Practice Address - Street 1:4750 BAILEY BOSWELL RD.
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76179
Practice Address - Country:US
Practice Address - Phone:682-316-7508
Practice Address - Fax:682-316-7511
Is Sole Proprietor?:No
Enumeration Date:2011-03-09
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36023183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist