Provider Demographics
NPI:1497705214
Name:BARRY L HARRELL MD PA
Entity Type:Organization
Organization Name:BARRY L HARRELL MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:L
Authorized Official - Last Name:HARRELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-864-2659
Mailing Address - Street 1:PO BOX 7749
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77270-7749
Mailing Address - Country:US
Mailing Address - Phone:713-869-3000
Mailing Address - Fax:713-864-5577
Practice Address - Street 1:2120 ASHLAND ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-2418
Practice Address - Country:US
Practice Address - Phone:713-864-2659
Practice Address - Fax:713-864-5577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD6024174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00189UMedicare UPIN