Provider Demographics
NPI:1508514209
Name:HARRIS, INDIA R
Entity Type:Individual
Prefix:MS
First Name:INDIA
Middle Name:R
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 1:505 E EXCHANGE PKWY APT 11101
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75002-1765
Mailing Address - Country:US
Mailing Address - Phone:469-370-9738
Mailing Address - Fax:
Practice Address - Street 1:505 E EXCHANGE PKWY APT 11101
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75002-1765
Practice Address - Country:US
Practice Address - Phone:469-370-9738
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-13
Last Update Date:2022-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy