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NPI Code Detail

MEDICARE: MR. WILLIAM PHILLIP HARRIS JR. R.PH.

MEDICARE: MR. WILLIAM PHILLIP HARRIS JR. R.PH.
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
1183500000XPharmacist24481TX

General Provider Information

NPI Number : 1902132699
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. WILLIAM PHILLIP HARRIS JR. R.PH.
Provider Business Mailing Address
First Line : 503 MIZELL ST
Second Line :
City : DUNCANVILLE
State : TX
Zip : 75116-3203
Country : US
Telephone Number : 972-709-5030
Fax Number :
Provider Business Practice Location Address
First Line : 100 SE GREEN OAKS BLVD
Second Line :
City : ARLINGTON
State : TX
Zip : 76018-1640
Country : US
Telephone Number : 817-419-0585
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/30/2009
Last Update Date : 10/30/2009

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