Provider Demographics
| NPI: | 1841299864 |
|---|---|
| Name: | MORRIS, HOWARD G (MD) |
| Entity type: | Individual |
| Prefix: | |
| First Name: | HOWARD |
| Middle Name: | G |
| Last Name: | MORRIS |
| Suffix: | |
| Gender: | M |
| Credentials: | MD |
| Other - Prefix: | |
| Other - First Name: | |
| Other - Middle Name: | |
| Other - Last Name: | |
| Other - Suffix: | |
| Other - Last Name Type: | |
| Other - Credentials: | |
| Mailing Address - Street 1: | 2801 RICHMOND ROAD |
| Mailing Address - Street 2: | SUITE 362 |
| Mailing Address - City: | TEXARKANA |
| Mailing Address - State: | TX |
| Mailing Address - Zip Code: | 75503 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 903-293-4216 |
| Mailing Address - Fax: | 903-614-5617 |
| Practice Address - Street 1: | 2163 LIMA LOOP APT 07-021 |
| Practice Address - Street 2: | |
| Practice Address - City: | LAREDO |
| Practice Address - State: | TX |
| Practice Address - Zip Code: | 78045 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 903-293-4216 |
| Practice Address - Fax: | 903-614-2131 |
| Is Sole Proprietor?: | Yes |
| Enumeration Date: | 2005-07-20 |
| Last Update Date: | 2021-06-30 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| AR | N-7404 | 2085R0001X |
| IN | 01077040Z | 2085R0001X |
| TX | H4024 | 2085R0001X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 2085R0001X | Allopathic & Osteopathic Physicians | Radiology | Radiation Oncology |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| SC | 752268615 | Other | TRICARE/CHAMPUS |
| TN | D11H | Other | BLUE CROSS |
| TX | 0325987-01 | Medicaid | |
| AR | 50979 | Other | BLUE CROSS |
| TX | 00D11H | Medicare PIN |