Provider Demographics
NPI:1487651899
Name:HARRISON, MARY SUE (AUD)
Entity Type:Individual
Prefix:DR
First Name:MARY SUE
Middle Name:
Last Name:HARRISON
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21715 KINGSLAND BLVD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-2514
Mailing Address - Country:US
Mailing Address - Phone:281-578-7500
Mailing Address - Fax:281-492-9204
Practice Address - Street 1:21715 KINGSLAND BLVD
Practice Address - Street 2:SUITE 105
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-2514
Practice Address - Country:US
Practice Address - Phone:281-578-7500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-30
Last Update Date:2018-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX109000237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter