Provider Demographics
NPI:1922233006
Name:HARRIS, TAMARA E (OT)
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:E
Last Name:HARRIS
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 N. VALLEY PARKWAY
Mailing Address - Street 2:SUITE 380
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067-3438
Mailing Address - Country:US
Mailing Address - Phone:972-353-5437
Mailing Address - Fax:
Practice Address - Street 1:401 N. VALLEY PARKWAY
Practice Address - Street 2:SUITE 380
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-3438
Practice Address - Country:US
Practice Address - Phone:972-353-5437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-19
Last Update Date:2009-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX101765225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist