Provider Demographics
NPI:1134372139
Name:HARRIS, ALLEN (SURGICAL FIRST ASSIS)
Entity type:Individual
Prefix:MR
First Name:ALLEN
Middle Name:
Last Name:HARRIS
Suffix:
Gender:M
Credentials:SURGICAL FIRST ASSIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:902 ROLLING GRV
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78253-5759
Mailing Address - Country:US
Mailing Address - Phone:210-315-1172
Mailing Address - Fax:210-560-2362
Practice Address - Street 1:902 ROLLING GRV
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78253-5759
Practice Address - Country:US
Practice Address - Phone:210-315-1172
Practice Address - Fax:210-560-2362
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-04
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
246ZC0007X
TX019492251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant