Healthcare Provider Details

I. General information

NPI: 1790762615
Provider Name (Legal Business Name): HOWARD WALKER HARRIS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/30/2005
Last Update Date: 02/25/2025
Certification Date: 02/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2425 HIGHWAY 121
BEDFORD TX
76021-5013
US

IV. Provider business mailing address

2425 HIGHWAY 121
BEDFORD TX
76021-5013
US

V. Phone/Fax

Practice location:
  • Phone: 817-540-4477
  • Fax: 817-540-5633
Mailing address:
  • Phone: 817-540-4477
  • Fax: 817-540-5633

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License NumberL6057
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberL6057
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: