Provider Demographics
NPI:1659668481
Name:HARRIS, WILLIAM (CI)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:
Last Name:HARRIS
Suffix:
Gender:M
Credentials:CI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2345 50TH STREET
Mailing Address - Street 2:MANAGED CARE CENTER FOR ADDICTIVE/OTHER DISORDERS, INC.
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79412
Mailing Address - Country:US
Mailing Address - Phone:806-780-8300
Mailing Address - Fax:806-780-8383
Practice Address - Street 1:1705 N. FM. 179
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79416
Practice Address - Country:US
Practice Address - Phone:806-797-8003
Practice Address - Fax:806-797-7916
Is Sole Proprietor?:No
Enumeration Date:2011-06-30
Last Update Date:2011-06-30
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)