Provider Demographics
NPI:1740567841
Name:HARLOW, STEPHEN RAY (PHD, CLS, CLC)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:RAY
Last Name:HARLOW
Suffix:
Gender:M
Credentials:PHD, CLS, CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 LAURENCE
Mailing Address - Street 2:#108
Mailing Address - City:HEATH
Mailing Address - State:TX
Mailing Address - Zip Code:75032
Mailing Address - Country:US
Mailing Address - Phone:214-577-9311
Mailing Address - Fax:972-771-4588
Practice Address - Street 1:201 LAURENCE
Practice Address - Street 2:#108
Practice Address - City:HEATH
Practice Address - State:TX
Practice Address - Zip Code:75032
Practice Address - Country:US
Practice Address - Phone:214-577-9311
Practice Address - Fax:972-771-4588
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-03
Last Update Date:2011-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX25318455247ZC0005X
TX9914146247ZC0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247ZC0005XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyClinical Laboratory Director, Non-physician