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General NPI Number Information
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NPI Number | 1952650947
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Entity Type | Individual
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Provider Name | SAMI MALAE HARRIS NP
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Gender | Female
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Dates
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Enumeration Date | 09/05/2012
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Last Update Date | 09/05/2012
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Provider Practice Location Address
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Address Line | 125 STATE HIGHWAY 31 E
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City | CHANDLER
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State | TX
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Zip | 75758-2376
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Country | US
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Telephone | 903-849-3862
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Fax | 903-849-4965
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Provider Business Mailing Address
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Address Line | 901 TURTLE CREEK DR
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City | TYLER
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State | TX
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Zip | 75701-1947
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Country | US
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Telephone | 903-596-3651
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Fax | 903-594-2038
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 715690
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License Number State | TX
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