Provider Demographics
NPI:1497797138
Name:HARRIS, DANEEN
Entity Type:Individual
Prefix:MS
First Name:DANEEN
Middle Name:
Last Name:HARRIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13710 BLUFFGATE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-1930
Mailing Address - Country:US
Mailing Address - Phone:210-887-9266
Mailing Address - Fax:
Practice Address - Street 1:520 E EUCLID AVE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78212-4414
Practice Address - Country:US
Practice Address - Phone:210-242-0020
Practice Address - Fax:210-475-9806
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2013-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX241108367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered