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NPI Code Detail

MEDICARE: MR. JONATHAN B HARRIS C.R.N.A.

MEDICARE: MR. JONATHAN B HARRIS C.R.N.A.
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
1367500000XCertified Registered Nurse Anesthetist628394TX

General Provider Information

NPI Number : 1720022213
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JONATHAN B HARRIS C.R.N.A.
Provider Business Mailing Address
First Line : 211 HARWOOD DR
Second Line :
City : LEAGUE CITY
State : TX
Zip : 77573-4343
Country : US
Telephone Number : 281-535-5902
Fax Number :
Provider Business Practice Location Address
First Line : 18300 SAINT JOHN DR
Second Line :
City : HOUSTON
State : TX
Zip : 77058-6302
Country : US
Telephone Number : 281-333-5503
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2006
Last Update Date : 07/10/2007

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