Basic Information
| Provider Information | |||||||||
| NPI: | 1457799512 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HARRIS | ||||||||
| FirstName: | WILLIAM | ||||||||
| MiddleName: | HOUSTON | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2379 MELVIN DOUGLAS RD | ||||||||
| Address2: | |||||||||
| City: | MARIETTA | ||||||||
| State: | OK | ||||||||
| PostalCode: | 734487588 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5802207789 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 744 W 9TH ST | ||||||||
| Address2: | |||||||||
| City: | TULSA | ||||||||
| State: | OK | ||||||||
| PostalCode: | 741279020 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9185995922 | ||||||||
| FaxNumber: | 9185995949 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/11/2013 | ||||||||
| LastUpdateDate: | 05/12/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207P00000X | 3026 | WV | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.