Provider Demographics
NPI:1518269471
Name:DELCAMBRE HARRIS, GEORGETTE
Entity Type:Individual
Prefix:
First Name:GEORGETTE
Middle Name:
Last Name:DELCAMBRE 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 1:1201 REDFORD
Mailing Address - Street 2:#2219A
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77034
Mailing Address - Country:US
Mailing Address - Phone:713-878-3753
Mailing Address - Fax:
Practice Address - Street 1:1201 REDFORD ST
Practice Address - Street 2:#2219A
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77034-1861
Practice Address - Country:US
Practice Address - Phone:713-878-3753
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-29
Last Update Date:2010-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXW15487343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)