NPI 1114476827

Otha Harris, FOUNDERCEO

Practitioner Private Vehicle Dallas, TX

Practice location

Address: 4208 Cabell Dr APT 532, Dallas, TX 75204-3697
Phone: (469) 719-5589
Mailing address: PO Box 132195, Dallas, TX 75313-2195

Registered specialties

Private Vehicle Primary

Transportation Services Taxonomy 347C00000X

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Registry record

NPI: 1114476827
Entity type: Individual
Sex (as registered): Male
NPI issued: 23 Sep 2016
Record last updated: 23 Sep 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.