MEDICARE: DR. RAYMOND KING HARRELL SR. DDS

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	1223G0001X	General Practice Dentistry	6205	TX

General Provider Information

NPI Number	:	1750583381
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAYMOND KING HARRELL SR. DDS

Provider Business Mailing Address
First Line	:	2536 AMHERST ST
Second Line	:	STE A
City	:	HOUSTON
State	:	TX
Zip	:	77005-3207
Country	:	US
Telephone Number	:	713-490-8880
Fax Number	:	713-490-6464

Provider Business Practice Location Address
First Line	:	6502 GARTH RD
Second Line	:	STE 100
City	:	BAYTOWN
State	:	TX
Zip	:	77521-9888
Country	:	US
Telephone Number	:	713-490-8880
Fax Number	:	713-490-6464

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

Provider Enumeration Date	:	06/05/2007
Last Update Date	:	01/25/2026

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