Individual
WALLACE E. HARRIS II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S.
Contact information
Practice address
14951 BELLOWS FALLS LN, 634, HUMBLE, TX 77396-6103
(281) 683-5053
Mailing address
14951 BELLOWS FALLS LN., 634, HUMBLE, TX 77396
(281) 683-5053
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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