Provider Demographics
NPI:1912985631
Name:HARRIS, STEVEN ALBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:ALBERT
Last Name:HARRIS
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 1:7231 LAKEWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75214-3511
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3801 GASTON AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-1541
Practice Address - Country:US
Practice Address - Phone:214-823-9630
Practice Address - Fax:214-821-3556
Is Sole Proprietor?:No
Enumeration Date:2006-01-03
Last Update Date:2011-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTXH0432207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX097449502Medicaid
TXE02177Medicare UPIN
TX82W101Medicare ID - Type Unspecified