Provider Demographics
NPI:1649156100
Name:HARRIS, TIFFANY SHUNTA
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:SHUNTA
Last Name:HARRIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14214 PLUM SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-3854
Mailing Address - Country:US
Mailing Address - Phone:409-382-3965
Mailing Address - Fax:
Practice Address - Street 1:14214 PLUM SPRINGS DR
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-3854
Practice Address - Country:US
Practice Address - Phone:409-382-3965
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-12
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator