| |
4000 Sunrise Rd Ste 3200, Round Rock, TX 78665-1239 | |
(512) 248-9355 | |
(512) 233-1010 |
Full Name | |
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Type | Facility |
Speciality | Chiropractor |
Location | 4000 Sunrise Rd Ste 3200, Round Rock, Texas |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1366858276 | NPI | - | NPPES |
P00318024 | Other | TX | RAILROAD MEDICARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | 9952 (Texas) | Primary |
Provider Name | Woodrow Bolden Harris |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1881782621 PECOS PAC ID: 3870504632 Enrollment ID: I20060509000338 |
Mailing Address | Practice Location Address |
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4000 Sunrise Rd Ste 3200, Round Rock, TX 78665-1239 Ph: (512) 248-9355 | 4000 Sunrise Rd Ste 3200, Round Rock, TX 78665-1239 Ph: (512) 248-9355 |
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