Individual
SAMANTHA ANN EVANKOVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CAA
Contact information
Practice address
6431 FANNIN ST, SUITE 5.020, HOUSTON, TX 77030-1501
(713) 500-6202
(713) 500-0648
Mailing address
6431 FANNIN ST, SUITE 5.020, HOUSTON, TX 77030-1501
(713) 500-6202
(713) 500-0648
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
75000023A
IN
367H00000X
Anesthesiologist Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001260391
ANTHEM PTAN
IN
Enumeration date
07/25/2014
Last updated
12/03/2024
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