Healthcare Provider Details

I. General information

NPI: 1871052209
Provider Name (Legal Business Name): HARRISON WILLIAM TORRES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/15/2019
Last Update Date: 07/08/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

703 E MARSHALL AVE STE 5008
LONGVIEW TX
75601-5557
US

IV. Provider business mailing address

1501 KINGS HIGHWAY
SHREVEPORT LA
71103
US

V. Phone/Fax

Practice location:
  • Phone: 903-315-4455
  • Fax: 903-315-2466
Mailing address:
  • Phone: 318-626-2750
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberV0199
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: