Basic Information
Provider Information
NPI: 1356010946
EntityType: 2
ReplacementNPI:  
OrganizationName: SCOTT A HARRIS PLLC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 660 W CAMPBELL RD STE 102
Address2:  
City: RICHARDSON
State: TX
PostalCode: 750803473
CountryCode: US
TelephoneNumber: 9722313439
FaxNumber: 9722310260
Practice Location
Address1: 660 W CAMPBELL RD STE 102
Address2:  
City: RICHARDSON
State: TX
PostalCode: 750803473
CountryCode: US
TelephoneNumber: 9722313439
FaxNumber: 9722310260
Other Information
ProviderEnumerationDate: 09/08/2021
LastUpdateDate: 09/08/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: HARRIS
AuthorizedOfficialFirstName: SCOTT
AuthorizedOfficialMiddleName: ANDREW
AuthorizedOfficialTitleorPosition: MANAGER
AuthorizedOfficialTelephone: 9727625579
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: DR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: O.D.
NPICertificationDate: 06/30/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
152W00000X  Y193400000X SINGLE SPECIALTY GROUPEye and Vision Services ProvidersOptometrist 

No ID Information.


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