Individual
DR. GLENNA G HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D., FAAP
Contact information
Practice address
515 LONDONDERRY LN, DENTON, TX 76205-5337
(940) 484-0065
(940) 484-2205
Mailing address
515 LONDONDERRY LN, DENTON, TX 76205-5337
(940) 484-0065
(940) 484-2205
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
F1626
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0028590
AMERIGROUP
TX
01
—
0097BD
BC/BS
TX
05
—
134906002
—
TX
Enumeration date
08/29/2006
Last updated
04/01/2014
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