Provider Demographics
NPI:1295862878
Name:HARRIS, GERALD E JR (PHD, BCBA)
Entity Type:Individual
Prefix:DR
First Name:GERALD
Middle Name:E
Last Name:HARRIS
Suffix:JR
Gender:M
Credentials:PHD, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3730 KIRBY DR STE 540
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77098-3930
Mailing Address - Country:US
Mailing Address - Phone:713-353-0254
Mailing Address - Fax:713-353-0253
Practice Address - Street 1:3730 KIRBY DR STE 540
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77098-3930
Practice Address - Country:US
Practice Address - Phone:713-353-0254
Practice Address - Fax:713-353-0253
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2-3163103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical