Provider Demographics
NPI:1881991552
Name:HARRIS, PAUL D (DM(P), ND, CPT)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:D
Last Name:HARRIS
Suffix:
Gender:M
Credentials:DM(P), ND, CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6465 S YALE AVE
Mailing Address - Street 2:STE 804
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-7823
Mailing Address - Country:US
Mailing Address - Phone:918-551-6600
Mailing Address - Fax:
Practice Address - Street 1:6465 S YALE AVE
Practice Address - Street 2:STE 804
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-7823
Practice Address - Country:US
Practice Address - Phone:918-551-6600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-16
Last Update Date:2011-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133N00000X
TX2855482175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No133N00000XDietary & Nutritional Service ProvidersNutritionist