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General NPI Number Information
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NPI Number | 1225071343
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Entity Type | Individual
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Provider Name | GREGORY WADE HARRISON O.D.
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Gender | Male
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Dates
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Enumeration Date | 06/14/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 1900 PRESTON RD SUITE 265
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City | PLANO
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State | TX
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Zip | 75093-5175
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Country | US
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Telephone | 972-519-0006
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Fax | 972-519-0669
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Provider Business Mailing Address
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Address Line | 7001 W PARKER RD #918
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City | PLANO
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State | TX
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Zip | 75093-8614
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Country | US
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Telephone | 972-306-7705
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Fax |
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 04019T
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License Number State | TX
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