MEDICARE: DR. LATOYA HARRIS D.C.

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	111N00000X	Chiropractor	14610	TX

General Provider Information

NPI Number	:	1730778366
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LATOYA HARRIS D.C.

Provider Business Mailing Address
First Line	:	3212 DISCOVERY DR
Second Line	:
City	:	OAK POINT
State	:	TX
Zip	:	75068-0709
Country	:	US
Telephone Number	:	972-768-4097
Fax Number	:

Provider Business Practice Location Address
First Line	:	222 W JEFFERSON BLVD STE C
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75208-4512
Country	:	US
Telephone Number	:	972-768-4097
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/18/2021
Last Update Date	:	01/18/2021

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