Active NPI
Bradley S Harris, D.M.D.
- Pediatric Dentistry
- Conroe, TX
National Provider Identifier
1861628851
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 24481
- Practice address
- 2247 N Loop 336 W
Conroe, TX 77304-3520 - Phone
- (936) 756-0659
- NPI assigned
- Jun 3, 2009
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 24481 | TX | Primary |
Addresses
Primary practice location
2247 N Loop 336 W
Conroe, TX 77304-3520
Mailing address
12802 Lake Island Cir
Montgomery, TX 77356-5680
Phone (713) 703-0737
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24481 | TX | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bgse, Inc | Pediatric Dentistry | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Pediatric Dentistry
- Conroe, TX
- NPI 1588901987
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1243987200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1357516800000",
"number": "1861628851",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12802 LAKE ISLAND CIR",
"city": "MONTGOMERY",
"state": "TX",
"postal_code": "773565680",
"telephone_number": "713-703-0737"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2247 N LOOP 336 W",
"city": "CONROE",
"state": "TX",
"postal_code": "773043520",
"telephone_number": "936-756-0659"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS",
"first_name": "BRADLEY",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-06-03",
"last_updated": "2013-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "TX",
"license": "24481",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Conroe, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.