Active NPI
Otha Harris III, FOUNDER, C.E.O.,
- Private Vehicle
- Dallas, TX
National Provider Identifier
1114476827
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Private Vehicle
- Practice address
- 4208 Cabell Dr Apt 532
Dallas, TX 75204-3697 - Phone
- (469) 719-5589
- NPI assigned
- Sep 23, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Private Vehicle | 347C00000X | Primary |
Addresses
Primary practice location
4208 Cabell Dr Apt 532
Dallas, TX 75204-3697
Mailing address
PO Box 132195
Dallas, TX 75313-2195
Phone (469) 719-5589
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1474588800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1474588800000",
"number": "1114476827",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 132195",
"city": "DALLAS",
"state": "TX",
"postal_code": "753132195",
"telephone_number": "469-719-5589"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4208 CABELL DR APT 532",
"city": "DALLAS",
"state": "TX",
"postal_code": "752043697",
"telephone_number": "469-719-5589"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS",
"first_name": "OTHA",
"name_suffix": "III",
"credential": "FOUNDER, C.E.O.,",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-09-23",
"last_updated": "2016-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "347C00000X",
"taxonomy_group": "",
"desc": "Private Vehicle",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.