Provider Demographics
NPI:1710196431
Name:HARRIS, MELVIN E (MD)
Entity Type:Individual
Prefix:DR
First Name:MELVIN
Middle Name:E
Last Name:HARRIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16135 PRESTON RD
Mailing Address - Street 2:130
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248-3599
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:16135 PRESTON RD
Practice Address - Street 2:130
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75248-3599
Practice Address - Country:US
Practice Address - Phone:214-724-5726
Practice Address - Fax:972-233-6977
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD6026207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX81W300Medicare ID - Type Unspecified
TXC16651Medicare UPIN