Individual
CANAAN LAVELLE HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1315 ST JOSEPH PKWY STE 1001, HOUSTON, TX 77002-8231
(713) 658-1900
(713) 658-1971
Mailing address
1315 ST JOSEPH PKWY STE 1001, HOUSTON, TX 77002-8231
(713) 658-1900
(713) 658-1971
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
G1424
TX
174400000X
Specialist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
035694101
—
TX
01
—
760356749
TAX IDENTIFICATION NUMBER
TX
05
—
760356749
—
TX
Enumeration date
01/08/2007
Last updated
01/23/2020
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