Basic Information
| Provider Information | |||||||||
| NPI: | 1225264880 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HARRIS | ||||||||
| FirstName: | ANDREA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6410 FANNIN ST | ||||||||
| Address2: | SUITE 500 | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770303000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8323256516 | ||||||||
| FaxNumber: | 7135122222 | ||||||||
| Practice Location | |||||||||
| Address1: | 6410 FANNIN ST | ||||||||
| Address2: | SUITE 500 | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770303000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8323256516 | ||||||||
| FaxNumber: | 7135122222 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/09/2009 | ||||||||
| LastUpdateDate: | 08/03/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | MD2012-0778 | NM | N | Allopathic & Osteopathic Physicians | Pediatrics | 2080P0202X | MD2012-0778 | NM | N | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Cardiology | 2080P0202X | P7118 | TX | N | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Cardiology | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 208000000X | P7118 | TX | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.