Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 28088 | TX |
NPI | 1124383104 |
---|---|
Provider Name | Dr. Muhammad Haris |
First Address | Cedar Park, TX 78613-1537 |
Second Address | Cedar Park, TX 78613-1537 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2012 |
Last Update Date | 06/07/2012 |