Healthcare Provider Details

I. General information

NPI: 1477780849
Provider Name (Legal Business Name): GABRIEL T HARRIS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2009
Last Update Date: 04/10/2026
Certification Date: 04/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1115 E 20TH ST
SIOUX FALLS SD
57105-1013
US

IV. Provider business mailing address

1115 E 20TH ST
SIOUX FALLS SD
57105-1013
US

V. Phone/Fax

Practice location:
  • Phone: 605-339-1783
  • Fax: 888-869-1341
Mailing address:
  • Phone: 605-339-1783
  • Fax: 888-869-1341

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number14395
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: