Harris, Jacqueline

Harris, Jacqueline is an individual health care provider with primary practice located at 800 5Th Ave Ste 300 , Fort Worth TX 76104-7303. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as her primary health care specialty. Harris, Jacqueline can be contacted via phone (817) 878-5300.

Contact Information

Primary practice address
800 5Th Ave Ste 300 Fort Worth TX 76104-7303
Fax: (817) 878-5321
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA03245 Texas

Profile Details

NPI number 1821016403
LBN Legal business name Harris, Jacqueline
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 18th, 2006
Last updated Sep 9th, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1821016403 NPPES
Texas Other 1821016403 BLUE CROSS BLUE SHIELD

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