Organization
OTO-HNS
Active
Other names
Assoc of Ear, Nose & Throat Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL BRADLEY EVASN M.D. (OWNER)
(972) 420-7212
Entity
Organization
Contact information
Practice address
324 W MAIN ST, SUITE 100, LEWISVILLE, TX 75057-3866
(972) 420-7212
(972) 420-8812
Mailing address
324 W MAIN ST, SUITE 100, LEWISVILLE, TX 75057-3866
(972) 420-7212
(972) 420-8812
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
M3218
TX
Other
Enumeration date
04/15/2008
Last updated
04/15/2008
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