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General NPI Number Information
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NPI Number | 1417201104
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Entity Type | Individual
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Provider Name | SCOTT ANDREW HARRIS O.D.
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Gender | Male
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Dates
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Enumeration Date | 11/01/2012
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Last Update Date | 06/02/2021
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Provider Practice Location Address
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Address Line | 660 W CAMPBELL RD STE 102
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City | RICHARDSON
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State | TX
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Zip | 75080
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Country | US
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Telephone | 972-231-9595
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Fax | 972-664-1629
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Provider Business Mailing Address
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Address Line | 660 W CAMPBELL RD STE 102
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City | RICHARDSON
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State | TX
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Zip | 75080-3469
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Country | US
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Telephone | 972-231-3439
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Fax | 972-231-0260
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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 | 8090
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License Number State | TX
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