Provider Demographics
NPI:1922291145
Name:PAUL HARRIS, M.D.
Entity Type:Organization
Organization Name:PAUL HARRIS, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:C
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:325-670-5580
Mailing Address - Street 1:1100 N 19TH ST
Mailing Address - Street 2:STE 4B
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79601-2344
Mailing Address - Country:US
Mailing Address - Phone:325-670-5580
Mailing Address - Fax:325-670-5586
Practice Address - Street 1:1100 N 19TH ST
Practice Address - Street 2:STE 4B
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79601-2344
Practice Address - Country:US
Practice Address - Phone:325-670-5580
Practice Address - Fax:325-670-5586
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-21
Last Update Date:2007-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMDG81622084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0081HUOtherBCBS
TX0081HUOtherBCBS
TX00557FMedicare PIN