Healthcare Provider Details

I. General information

NPI: 1649342841
Provider Name (Legal Business Name): STEPHEN R HARRIS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 03/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7300 REMCON CIR SUITE 200
EL PASO TX
79912-1642
US

IV. Provider business mailing address

7300 REMCON CIR STE 200
EL PASO TX
79912-1642
US

V. Phone/Fax

Practice location:
  • Phone: 915-532-3600
  • Fax: 915-532-3600
Mailing address:
  • Phone: 915-532-3600
  • Fax: 915-532-8999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberH9088
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberH9088
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: