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NPI Code Detail

MEDICARE: DR. WOODROW BOLDEN HARRIS III D.C.

MEDICARE: DR. WOODROW BOLDEN HARRIS III 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
1111N00000XChiropractor9952TX

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00318024OTHERTXRAILROAD MEDICARE

General Provider Information

NPI Number : 1881782621
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WOODROW BOLDEN HARRIS III D.C.
Provider Business Mailing Address
First Line : 4000 SUNRISE RD
Second Line : BLDG. 1 STE. 1200
City : ROUND ROCK
State : TX
Zip : 78665-1519
Country : US
Telephone Number : 512-248-9355
Fax Number : 512-233-1010
Provider Business Practice Location Address
First Line : 4000 SUNRISE RD
Second Line : BLDG. 1 STE. 1200
City : ROUND ROCK
State : TX
Zip : 78665-1519
Country : US
Telephone Number : 512-248-9355
Fax Number : 512-233-1010
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/10/2006
Last Update Date : 02/25/2015

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