Provider Demographics
NPI:1205149606
Name:HARVEY, JOHN WESLEY (MS,LAT,ATC)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:WESLEY
Last Name:HARVEY
Suffix:
Gender:M
Credentials:MS,LAT,ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:4127 FRIAR POINT RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77047-1202
Mailing Address - Country:US
Mailing Address - Phone:713-738-5079
Mailing Address - Fax:713-734-6591
Practice Address - Street 1:3100 CLEBURNE ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77004-4501
Practice Address - Country:US
Practice Address - Phone:713-313-7123
Practice Address - Fax:713-313-1045
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-14
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT02672255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer