Provider Demographics
NPI:1902132699
Name:HARRIS, WILLIAM PHILLIP JR (RPH)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:PHILLIP
Last Name:HARRIS
Suffix:JR
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 1:503 MIZELL ST
Mailing Address - Street 2:
Mailing Address - City:DUNCANVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75116-3203
Mailing Address - Country:US
Mailing Address - Phone:972-709-5030
Mailing Address - Fax:
Practice Address - Street 1:100 SE GREEN OAKS BLVD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76018-1640
Practice Address - Country:US
Practice Address - Phone:817-419-0585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-30
Last Update Date:2009-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24481183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist