Provider Demographics
NPI:1003979899
Name:HARRIS, ANNETTE (MD)
Entity type:Individual
Prefix:DR
First Name:ANNETTE
Middle Name:
Last Name:HARRIS
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2338 TANGLEY STREET
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77005
Mailing Address - Country:US
Mailing Address - Phone:713-660-9444
Mailing Address - Fax:713-660-9466
Practice Address - Street 1:6909 GREENBRIAR DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-3205
Practice Address - Country:US
Practice Address - Phone:713-660-9444
Practice Address - Fax:713-660-9466
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X
TXH7614207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXF74687Medicare UPIN
TX81080KMedicare ID - Type Unspecified