Provider Demographics
NPI:1245300615
Name:HARRIS, JUDY V (RPH)
Entity type:Individual
Prefix:
First Name:JUDY
Middle Name:V
Last Name:HARRIS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1441 S MIDLOTHIAN PKWY STE 140
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:TX
Mailing Address - Zip Code:76065-5592
Mailing Address - Country:US
Mailing Address - Phone:972-775-5222
Mailing Address - Fax:972-775-5444
Practice Address - Street 1:1441 S MIDLOTHIAN PKWY STE 140
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:TX
Practice Address - Zip Code:76065-5592
Practice Address - Country:US
Practice Address - Phone:972-775-5222
Practice Address - Fax:972-775-5444
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24128183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist