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General NPI Number Information
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NPI Number | 1639165749
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Entity Type | Individual
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Provider Name | JEFFREY THEODORE HARRIS M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/23/2005
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Last Update Date | 08/31/2010
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Provider Practice Location Address
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Address Line | 7940 FLOYD CURL DR SUITE 620
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City | SAN ANTONIO
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State | TX
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Zip | 78229-3905
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Country | US
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Telephone | 210-593-0237
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Fax | 210-593-0376
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Provider Business Mailing Address
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Address Line | 7940 FLOYD CURL DR SUITE 620
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City | SAN ANTONIO
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State | TX
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Zip | 78229-3905
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Country | US
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Telephone | 210-593-0237
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Fax | 210-593-0376
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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 | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 24495
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License Number State | AL
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