Provider Demographics
NPI:1417201104
Name:HARRIS, SCOTT ANDREW (OD)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:ANDREW
Last Name:HARRIS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:660 W CAMPBELL RD
Mailing Address - Street 2:STE 102
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-3469
Mailing Address - Country:US
Mailing Address - Phone:972-231-3439
Mailing Address - Fax:972-231-0260
Practice Address - Street 1:660 W CAMPBELL RD
Practice Address - Street 2:STE 102
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080
Practice Address - Country:US
Practice Address - Phone:972-231-9595
Practice Address - Fax:972-664-1629
Is Sole Proprietor?:No
Enumeration Date:2012-11-01
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8090152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist