Provider Demographics
NPI:1952518524
Name:HARRIS, DANIEL P (PHD CCC-A)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:P
Last Name:HARRIS
Suffix:
Gender:M
Credentials:PHD CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7201 MANCHACA RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-5259
Mailing Address - Country:US
Mailing Address - Phone:512-443-3577
Mailing Address - Fax:512-445-6027
Practice Address - Street 1:7201 MANCHACA RD
Practice Address - Street 2:SUITE B
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-5259
Practice Address - Country:US
Practice Address - Phone:512-443-3577
Practice Address - Fax:512-445-6027
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50612231H00000X
TX14067235Z00000X
TX90067237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Not Answered235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Not Answered237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX580019Medicare ID - Type Unspecified