Provider Demographics
NPI:1881814382
Name:HARRIS, MARGO (PT)
Entity type:Individual
Prefix:
First Name:MARGO
Middle Name:
Last Name:HARRIS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5739 HORSESHOE FLS
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-6913
Mailing Address - Country:US
Mailing Address - Phone:281-778-7601
Mailing Address - Fax:
Practice Address - Street 1:8615 FREEPORT PKWY STE 225
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063-1984
Practice Address - Country:US
Practice Address - Phone:800-284-0429
Practice Address - Fax:800-482-0198
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1160210225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist