Provider Demographics
NPI:1184754194
Name:MAYES, JOHN ARTHUR (ATC)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:ARTHUR
Last Name:MAYES
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:773 FORTUNE ST.
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77088-1957
Mailing Address - Country:US
Mailing Address - Phone:936-857-4028
Mailing Address - Fax:936-857-3008
Practice Address - Street 1:773 FORTUNE ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77088-6315
Practice Address - Country:US
Practice Address - Phone:936-857-4028
Practice Address - Fax:936-857-3008
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT06052255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer