Provider Demographics
NPI:1508070368
Name:HARRIS, LELAND A (DDS)
Entity Type:Individual
Prefix:DR
First Name:LELAND
Middle Name:A
Last Name:HARRIS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4601 CENTER ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:DEER PARK
Mailing Address - State:TX
Mailing Address - Zip Code:77536-6352
Mailing Address - Country:US
Mailing Address - Phone:281-479-5550
Mailing Address - Fax:281-479-4417
Practice Address - Street 1:4601 CENTER ST
Practice Address - Street 2:SUITE A
Practice Address - City:DEER PARK
Practice Address - State:TX
Practice Address - Zip Code:77536-6352
Practice Address - Country:US
Practice Address - Phone:281-479-5550
Practice Address - Fax:281-479-4417
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX116541223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics