MEDICARE: MR. JOHN WESLEY HARVEY MS,LAT,ATC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2255A2300X	Athletic Trainer	AT0267	TX

General Provider Information

NPI Number	:	1205149606
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOHN WESLEY HARVEY MS,LAT,ATC

Provider Business Mailing Address
First Line	:	4127 FRIAR POINT RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77047-1202
Country	:	US
Telephone Number	:	713-738-5079
Fax Number	:	713-734-6591

Provider Business Practice Location Address
First Line	:	3100 CLEBURNE ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77004-4501
Country	:	US
Telephone Number	:	713-313-7123
Fax Number	:	713-313-1045

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2010
Last Update Date	:	06/21/2026

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