MEDICARE: ROBERT A. HARRISON CST

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	246ZS0410X	Surgical Technologist

General Provider Information

NPI Number	:	1346452570
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROBERT A. HARRISON CST

Provider Business Mailing Address
First Line	:	7120 GREENHILL TRL
Second Line	:
City	:	NORTH RICHLAND HILLS
State	:	TX
Zip	:	76180-2726
Country	:	US
Telephone Number	:	817-485-6805
Fax Number	:	817-335-4663

Provider Business Practice Location Address
First Line	:	7120 GREENHILL TRL
Second Line	:
City	:	NORTH RICHLAND HILLS
State	:	TX
Zip	:	76180-2726
Country	:	US
Telephone Number	:	817-485-6805
Fax Number	:	817-335-4663

Authorized Official
Title or Position	:	SURGICAL ASSISTANT
Name	:	ROBERT ANDREW HARRISON
Credential	:	CST
Telephone Number	:	817-485-6845

Provider Enumeration Date	:	05/03/2007
Last Update Date	:	08/22/2020

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