Healthcare Provider Details

I. General information

NPI: 1689080624
Provider Name (Legal Business Name): JILL HARRIS MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2014
Last Update Date: 01/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6811 AUSTIN CENTER BLVD SUITE 400
AUSTIN TX
78731-3146
US

IV. Provider business mailing address

6811 AUSTIN CENTER BLVD SUITE 400
AUSTIN TX
78731-3146
US

V. Phone/Fax

Practice location:
  • Phone: 512-628-1840
  • Fax: 512-628-1841
Mailing address:
  • Phone: 512-628-1840
  • Fax: 512-628-1841

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: