Individual
JIMMY N HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3000 N INTERSTATE 35, DENTON, TX 76201-5119
(940) 898-7000
Mailing address
PO BOX 8549, FORT WORTH, TX 76124-0549
(817) 451-4208
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
H4383
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0035PJ
BLUE CROSS BLUE SHIELD
TX
05
—
122040206
—
TX
05
—
122040208
—
TX
01
—
8J7010
BLUE CROSS & BLUE SHIELD
TX
Enumeration date
10/24/2006
Last updated
03/05/2008
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