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Individual
WALLACE E. HARRIS II
Active
Individual
WALLACE E. HARRIS II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S.
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
TX
171M00000X
Case Manager/Care Coordinator
Primary
—
TX
347C00000X
Private Vehicle
23840944
TX
347E00000X
Transportation Broker
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1407157860
—
TX
Enumeration date
11/16/2010
Last updated
05/03/2015
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