Provider Demographics
NPI:1467717983
Name:HARPER, MELVIN D SR
Entity Type:Individual
Prefix:MR
First Name:MELVIN
Middle Name:D
Last Name:HARPER
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5504 CHIMNEY ROCK RD
Mailing Address - Street 2:
Mailing Address - City:FT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76112-2929
Mailing Address - Country:US
Mailing Address - Phone:682-225-7999
Mailing Address - Fax:
Practice Address - Street 1:5504 CHIMNEY ROCK RD
Practice Address - Street 2:
Practice Address - City:FT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76112-2929
Practice Address - Country:US
Practice Address - Phone:682-225-7999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-10
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator