Provider Demographics
NPI:1013456854
Name:HARRIS, KIMBERLY (BA)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:
Last Name:HARRIS
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8625 KING GEORGE DR.
Mailing Address - Street 2:BLDG A, STE 111
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75235
Mailing Address - Country:US
Mailing Address - Phone:214-631-7002
Mailing Address - Fax:214-631-6698
Practice Address - Street 1:8625 KING GEORGE DR
Practice Address - Street 2:BLDG A, STE 111
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-2215
Practice Address - Country:US
Practice Address - Phone:214-631-7002
Practice Address - Fax:214-631-6698
Is Sole Proprietor?:No
Enumeration Date:2017-02-13
Last Update Date:2017-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator