Provider Demographics
NPI:1073951240
Name:HARVEY, MAXINE AMY (DO)
Entity Type:Individual
Prefix:DR
First Name:MAXINE
Middle Name:AMY
Last Name:HARVEY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3338 OAKWELL CT STE 205
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78218-3088
Mailing Address - Country:US
Mailing Address - Phone:102-235-5612
Mailing Address - Fax:210-223-5093
Practice Address - Street 1:3338 OAKWELL CT STE 205
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78218-3088
Practice Address - Country:US
Practice Address - Phone:210-223-5561
Practice Address - Fax:210-223-5093
Is Sole Proprietor?:No
Enumeration Date:2013-06-11
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP60496217207W00000X, 208D00000X
390200000X
TXT9701207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2K5668OtherNOVITAS