Provider Demographics
NPI:1285647529
Name:LARRY D HARPER
Entity Type:Organization
Organization Name:LARRY D HARPER
Other - Org Name:UPSCALE EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:A
Authorized Official - Last Name:SOUTHALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-253-9908
Mailing Address - Street 1:PO BOX 721540
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77272
Mailing Address - Country:US
Mailing Address - Phone:713-787-6269
Mailing Address - Fax:713-270-9510
Practice Address - Street 1:8800 BISSONNET
Practice Address - Street 2:STE I
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074
Practice Address - Country:US
Practice Address - Phone:713-787-6269
Practice Address - Fax:713-270-9510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-15
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1013173416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX9729969610OtherBLUE CROSS BLUE SHIELD
TX166912901Medicaid
TXAMB355Medicare ID - Type Unspecified
VI=========Medicare UPIN