Provider Demographics
NPI:1609696129
Name:DR ERICA N HARRIS PA
Entity type:Organization
Organization Name:DR ERICA N HARRIS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERICA NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIS-GRANT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-263-0986
Mailing Address - Street 1:5270 N O CONNOR BLVD APT 1243
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75039-5720
Mailing Address - Country:US
Mailing Address - Phone:773-263-0986
Mailing Address - Fax:
Practice Address - Street 1:408 EAGLE SPIRIT DR
Practice Address - Street 2:
Practice Address - City:LINDALE
Practice Address - State:TX
Practice Address - Zip Code:75771-3300
Practice Address - Country:US
Practice Address - Phone:773-263-0986
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-10
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty