Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | K4077 | TX |
NPI | 1114905478 |
---|---|
Provider Name | Dr. Adam Isaac Harris |
First Address | San Antonio, TX 78265-7052 |
Second Address | San Antonio, TX 78258-3992 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/01/2006 |
Last Update Date | 12/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2805408 | AETNA HMO (01) | TX |
4600526 | AETNA PPO (01) | TX |
8G1480 | BCBS (01) | TX |
F36730 | (02) | TX |