Provider Demographics
NPI:1952933483
Name:HARRIS, WESLEY (RPH)
Entity Type:Individual
Prefix:
First Name:WESLEY
Middle Name:
Last Name:HARRIS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22030 MARKET PLACE DR
Mailing Address - Street 2:
Mailing Address - City:NEW CANEY
Mailing Address - State:TX
Mailing Address - Zip Code:77357-2016
Mailing Address - Country:US
Mailing Address - Phone:281-747-5089
Mailing Address - Fax:281-747-5200
Practice Address - Street 1:22030 MARKET PLACE DR
Practice Address - Street 2:
Practice Address - City:NEW CANEY
Practice Address - State:TX
Practice Address - Zip Code:77357-2016
Practice Address - Country:US
Practice Address - Phone:281-747-5089
Practice Address - Fax:281-747-5200
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-12
Last Update Date:2020-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX376351835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist