Provider Demographics
NPI:1982669560
Name:HARRISON, YI-MING T (OD)
Entity Type:Individual
Prefix:
First Name:YI-MING
Middle Name:T
Last Name:HARRISON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13376 RESEARCH BLVD
Mailing Address - Street 2:SUITE #124
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78750-3250
Mailing Address - Country:US
Mailing Address - Phone:512-336-2371
Mailing Address - Fax:512-336-2373
Practice Address - Street 1:13376 RESEARCH BLVD
Practice Address - Street 2:SUITE #124
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78750-3250
Practice Address - Country:US
Practice Address - Phone:512-336-2371
Practice Address - Fax:512-336-2373
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4981TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
U66108Medicare UPIN
TX8C8810Medicare PIN