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General NPI Number Information
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NPI Number | 1205944196
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Entity Type | Individual
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Provider Name | GLENNA G HARRIS M.D., FAAP
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Gender | Female
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Dates
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Enumeration Date | 08/29/2006
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Last Update Date | 04/01/2014
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Provider Practice Location Address
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Address Line | 515 LONDONDERRY LN
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City | DENTON
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State | TX
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Zip | 76205-5337
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Country | US
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Telephone | 940-484-0065
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Fax | 940-484-2205
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Provider Business Mailing Address
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Address Line | 515 LONDONDERRY LN
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City | DENTON
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State | TX
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Zip | 76205-5337
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Country | US
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Telephone | 940-484-0065
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Fax | 940-484-2205
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | F1626
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License Number State | TX
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