Basic Information
| Provider Information | |||||||||
| NPI: | 1144456674 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HARVEY | ||||||||
| FirstName: | ADRIAN | ||||||||
| MiddleName: | TIMOTHY | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 800 5TH AVE STE 500 | ||||||||
| Address2: | |||||||||
| City: | FORT WORTH | ||||||||
| State: | TX | ||||||||
| PostalCode: | 761047304 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8172504280 | ||||||||
| FaxNumber: | 8172504281 | ||||||||
| Practice Location | |||||||||
| Address1: | 800 5TH AVE STE 500 | ||||||||
| Address2: | |||||||||
| City: | FORT WORTH | ||||||||
| State: | TX | ||||||||
| PostalCode: | 761047304 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8172504280 | ||||||||
| FaxNumber: | 8172504281 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/10/2009 | ||||||||
| LastUpdateDate: | 03/01/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/28/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207T00000X | 6161 | AZ | N | Allopathic & Osteopathic Physicians | Neurological Surgery | 207T00000X | P3342 | TX | Y | Allopathic & Osteopathic Physicians | Neurological Surgery |
ID Information
| ID | Type | State | Issuer | Description | 8DK794 | 01 | TX | BCBS (MDACC) | OTHER | 302091901 (MDACC) | 05 | TX | MEDICAID | 811236 | 05 | AZ | MEDICAID |