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Individual
LARRY GENE HARRIS
Active
Individual
LARRY GENE HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
A751
SC
363AS0400X
Surgical Physician Assistant
Primary
—
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0058PA
—
SC
Enumeration date
06/29/2006
Last updated
12/13/2019
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