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NPI Code Detail

MEDICARE: CONSUELA DENISE HARRIS DNP

MEDICARE: CONSUELA DENISE HARRIS DNP
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
1363L00000XNurse Practitioner682737TX
2363L00000XNurse PractitionerAP115509TX
3363LP0808XPsychiatric/Mental Health Nurse PractitionerAP115509TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1682737OTHERTXSTATE LICENSE

General Provider Information

NPI Number : 1497802516
Entity Type Code : Individual
Provider Name (Legal Business Name) : CONSUELA DENISE HARRIS DNP
Provider Business Mailing Address
First Line : 1230 RIVER BEND DR STE 218
Second Line :
City : DALLAS
State : TX
Zip : 75247-4993
Country : US
Telephone Number : 469-401-5133
Fax Number :
Provider Business Practice Location Address
First Line : 2001 S MEDFORD DR
Second Line :
City : LUFKIN
State : TX
Zip : 75901-6260
Country : US
Telephone Number : 936-404-7738
Fax Number : 361-579-6913
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/03/2007
Last Update Date : 12/08/2025

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