Individual
LEANNA CAROL EVANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2100 AVENUE E, CISCO, TX 76437-5134
(432) 631-2855
Mailing address
2100 AVENUE E, CISCO, TX 76437-5134
(432) 631-2855
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
16262127
TX
Other
Enumeration date
09/10/2024
Last updated
09/10/2024
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