Individual
DR. LARRY JAMES EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2133 PEPPERRELL ST BLDG 3352, JBSA LACKLAND, TX 78236
(210) 292-8627
Mailing address
13830 PALATINE HL, SAN ANTONIO, TX 78253-7004
(707) 592-5805
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
17074
TX
Other
Enumeration date
10/13/2005
Last updated
08/21/2019
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