BLAKE ROBERT HARRIS (NPI# 1942629035) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942629035 |
| Entity Type | Individual |
| Full Name | BLAKE ROBERT HARRIS |
| Credential | PHD |
| Practice Address |
11010 Domain Dr Apt 11331 Austin TX 78758-7711 |
| Practice Telephone | 2148377999 |
| Mailing Telephone | 2148377999 |
| Enumeration Date | 2014-04-16 |
| Last Update Date | 2014-04-16 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TF0200X |
Psychologist Specialization: Forensic |
36688 | TX | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790861151 | Blake R Harris | Physician Assistant | 410 N Taylor Street, Weaverville, CA 96093 | 2006-10-28 |
| 1801424395 | Blake Christian Harris | Student in an Organized Health Care Education/Training Program | 2401 S 31st St, Department of Anesthesiology, Temple, TX 76508-0001 | 2020-03-30 |
| 1912234139 | Blake Harris | Case Manager/Care Coordinator | 3810 Winchester Rd, Southeast Mental Health Center, Memphis, TN 38118-6045 | 2009-11-09 |
| Street Address |
11010 DOMAIN DR APT 11331 |
| City | AUSTIN |
| State | TX |
| Zip Code | 78758-7711 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972902740 | Celesta Harris | Psychologist | 11010 Domain Dr, #11331, Austin, TX 78758-7711 | 2014-08-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225644065 | Seton Family of Doctors | Internal Medicine | 3001 Palm Way, D1 : 134-138, Austin, TX 78758 | 2020-09-17 |
| 1083243661 | Donna Bella Laurel Portillo | Pharmacist | 12221 N Mopac Expwy, Austin, TX 78758 | 2020-04-05 |
| 1881249092 | Elizabeth Logan Anderson | Behavioral Analyst | 2100 Kramer Ln., Suite 150, Austin, TX 78758 | 2019-08-05 |
| 1295388502 | Bridget Sue Morgan | Behavioral Analyst | 2100 Kramer Ln #150, Austin, TX 78758 | 2019-07-17 |
| 1508326885 | Jonathan James Runnels | Anesthesiologist Assistant | 12221n Mopac, Austin, TX 78758 | 2019-03-22 |
| 1427527324 | Nayely Gutierrez | Dietitian, Registered | 8606 Delaware Ct, Austin, TX 78758 | 2018-11-20 |
| 1720569635 | Shari Wright | Licensed Vocational Nurse | 12349 Metric Blvs # 425, Austin, TX 78758 | 2018-08-28 |
| 1528545456 | Alexis N Bongiorno | Registered Nurse | 11901 Hobby Horse Court, 1516, Austin, TX 78758 | 2018-07-24 |
| 1679072573 | Lori Scott | Counselor | 1600 Payton Gin Road, Austin, TX 78758 | 2018-02-06 |
| 1003322488 | Lisa Robyn Lee | Behavior Technician | 2018 W Rundberg Ln, #13d, Austin, TX 78758 | 2017-12-20 |
| Find all providers in zip 78758 | ||||
| Taxonomy Code | 103TF0200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Forensic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972902740 | Celesta Harris | Psychologist | 11010 Domain Dr, #11331, Austin, TX 78758-7711 | 2014-08-18 |
| 1366793309 | Chardonnay Nicole Poole | Psychologist | 2222 Western Trails Blvd Ste 202, Austin, TX 78745-1647 | 2012-10-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477044220 | Carl Normand Edwards | Psychologist | 4113 Sunflower Ln, Temple, TX 76502-4803 | 2018-05-27 |
| 1174983423 | Heather Nicole Twedell | Psychologist | 2770 Main St Ste 139, Frisco, TX 75033-4357 | 2016-02-29 |
| 1740551233 | Heather L Holder | Psychologist | 8627 Cinnamon Creek Dr Ste 601, San Antonio, TX 78240-1482 | 2012-01-16 |
| 1720101850 | Timothy James Proctor | Psychologist | 11882 Greenville Ave Ste 107, Dallas, TX 75243-3567 | 2007-04-06 |
| 1124140058 | Antoinette Rose Mcgarrahan | Psychologist | 12820 Hillcrest Rd Ste C125, Dallas, TX 75230-1526 | 2007-04-03 |
| 1689708125 | Marilyn Gayle Nobles | Psychologist | 2606 Presidio Dr Apt 4, Edinburg, TX 78539-3314 | 2007-03-15 |
| 1326180399 | Mary Alice Conroy | Psychologist | 794 Elkins Lk, Huntsville, TX 77340-7319 | 2007-02-13 |
| 1932111747 | Tim Branaman | Psychologist | 600 W Campbell Rd Ste 2, Richardson, TX 75080-3357 | 2006-08-12 |
| 1962918185 | Charlotte M. Kimmel | Psychologist | 2000 W 2nd Ave, Corsicana, TX 75110-2510 | 2017-12-26 |
| 1205365616 | David Edwin Mills Jr. | Psychologist | 1200 E. Brin Street, Terrell, TX 75161 | 2017-06-08 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.