Basic Information
Provider Information
NPI: 1033296777
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HARPER
FirstName: JOHN
MiddleName: K
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6711 S NEW BRAUNFELS AVE STE 100
Address2:  
City: SAN ANTONIO
State: TX
PostalCode: 782233002
CountryCode: US
TelephoneNumber: 2105317805
FaxNumber: 2105318172
Practice Location
Address1: 6711 S NEW BRAUNFELS AVE STE 100
Address2:  
City: SAN ANTONIO
State: TX
PostalCode: 782233002
CountryCode: US
TelephoneNumber: 2105317805
FaxNumber: 2105318172
Other Information
ProviderEnumerationDate: 11/01/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0804XJ2054TXY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry

No ID Information.


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