Provider Demographics
NPI:1295984003
Name:HARRIS COUNTY
Entity type:Organization
Organization Name:HARRIS COUNTY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:713-295-2578
Mailing Address - Street 1:6300 CHIMNEY ROCK RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77081-4502
Mailing Address - Country:US
Mailing Address - Phone:713-295-2570
Mailing Address - Fax:713-295-2582
Practice Address - Street 1:6300 CHIMNEY ROCK RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77081-4502
Practice Address - Country:US
Practice Address - Phone:713-295-2570
Practice Address - Fax:713-295-2582
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HARRIS COUNTY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-09-17
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX433044363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatricsGroup - Single Specialty