Individual
DR. BRENT REAVLEY HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1726 S BECKHAM AVE, TYLER, TX 75701-4435
(903) 593-0481
Mailing address
1726 S. BECKHAM AVE., TYLER, TX 75701-4435
(903) 593-0481
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
F6718
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
80P182
BCBSTX PROVIDER NUMBER
TX
01
—
8U0910
BLUE CROSS BLUE SHIELD TX
TX
Enumeration date
08/01/2006
Last updated
11/29/2007
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