MEDICARE: DR. BENJAMIN ANDREW HARRIS D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	9163	TX

General Provider Information

NPI Number	:	1144306465
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BENJAMIN ANDREW HARRIS D.C.

Provider Business Mailing Address
First Line	:	1333 LOCKHILL SELMA RD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78213-1915
Country	:	US
Telephone Number	:	210-363-2735
Fax Number	:

Provider Business Practice Location Address
First Line	:	11230 WEST AVE
Second Line	:	STE. 1109
City	:	SAN ANTONIO
State	:	TX
Zip	:	78213-1350
Country	:	US
Telephone Number	:	210-341-7040
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/29/2006
Last Update Date	:	07/08/2007

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