Provider Demographics
| NPI: | 1902090236 |
|---|---|
| Name: | HARRIS CHIROPRACTIC, P.A. |
| Entity Type: | Organization |
| Organization Name: | HARRIS CHIROPRACTIC, P.A. |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | PRESIDENT |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | JAMES |
| Authorized Official - Middle Name: | W |
| Authorized Official - Last Name: | HARRIS |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | DC |
| Authorized Official - Phone: | 940-696-5150 |
| Mailing Address - Street 1: | 4217 FAIRWAY BLVD |
| Mailing Address - Street 2: | |
| Mailing Address - City: | WICHITA FALLS |
| Mailing Address - State: | TX |
| Mailing Address - Zip Code: | 76308-2454 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 940-696-5150 |
| Mailing Address - Fax: | 940-696-0475 |
| Practice Address - Street 1: | 4217 FAIRWAY BLVD |
| Practice Address - Street 2: | |
| Practice Address - City: | WICHITA FALLS |
| Practice Address - State: | TX |
| Practice Address - Zip Code: | 76308-2454 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 940-696-5150 |
| Practice Address - Fax: | 940-696-0475 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2007-08-29 |
| Last Update Date: | 2009-01-21 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| TX | 5967 | 111N00000X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 111N00000X | Chiropractic Providers | Chiropractor | Group - Single Specialty |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| 1164506986 | Other | JAMES W. HARRIS INDIVIDUAL NPI NUMBER | |
| TX | 168284101 | Other | JAMES W. HARRIS, D.C. MEDICAID NUMBER |
| TX | 0006JF | Other | BLUE CROSS BLUE SHIELD GROUP PROVIDER NUMBER |
| TX | 1750311163 | Other | SHEILA M. CARLEY, D.C. INDIVIDUAL NPI NUMBER |
| TX | 603728 | Other | JAMES W. HARRIS, D.C. MEDICARE PIN |
| TX | 8G5331 | Other | SHEILA M. CARLEY, D.C. BLUE CROSS BLUE SHIELD INDIVIDUAL PROVIDER NUMBER |
| U90943 | Other | SHEILA M. CARLEY, D.C. UPIN | |
| TX | U37023 | Other | JAMES W. HARRIS, D.C. UPIN NUMBER |
| TX | 0076983 | Other | SHEILA M. CARLEY, D.C. BLUE LINK NUMBER |
| TX | 5967 | Other | JAMES W. HARRIS, D.C. CHIROPRACTIC STATE LICENSE NUMBER |
| TX | 609761 | Other | SHEILA M. CARLEY,D.C. MEDICARE UPIN |
| TX | 8237023 | Other | JAMES W. HARRIS, D.C. BLUE LINK NUMBER |
| TX | 9256 | Other | SHEILA M. CARLEY, D.C. CHIROPRACTIC STATE LICENSE NUMBER |
| TX | 176683401 | Other | SHEILA M.CARLEY, D.C. MEDICAID NUMBER |
| TX | 603728 | Other | JAMES W. HARRIS, D.C. MEDICARE UPIN |
| TX | 609761 | Other | SHEILA M. CARLEY, D.C. MEDICARE PIN |
| TX | 8G5330 | Other | JAMES W. HARRIS, D.C. BLUE CROSS BLUE SHIELD INDIVIDUAL PROVIDER NUMBER |
