Provider Demographics
NPI:1518061019
Name:HARRIS, DENNIS ALAN (DC)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:ALAN
Last Name:HARRIS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2234 E LOOP 820
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76112
Mailing Address - Country:US
Mailing Address - Phone:817-654-2200
Mailing Address - Fax:817-496-6011
Practice Address - Street 1:2234 E LOOP 820
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76112
Practice Address - Country:US
Practice Address - Phone:817-654-2200
Practice Address - Fax:817-496-6011
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4666111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001461501Medicaid
T20110Medicare UPIN
TX001461501Medicaid