Provider Demographics
NPI:1255058780
Name:HARRELL, LOUIS JEANUS JR
Entity type:Individual
Prefix:MR
First Name:LOUIS
Middle Name:JEANUS
Last Name:HARRELL
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 TRINITY DR
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:TX
Mailing Address - Zip Code:75146-2286
Mailing Address - Country:US
Mailing Address - Phone:214-717-9211
Mailing Address - Fax:
Practice Address - Street 1:213 TRINITY DR
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:TX
Practice Address - Zip Code:75146-2286
Practice Address - Country:US
Practice Address - Phone:214-717-9211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-25
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No343800000XTransportation ServicesSecured Medical Transport (VAN)