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Individual

DR. CHARLES ALEXANDER EVANS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M. D.

Contact information

Practice address
203 CHRISTIE ST., LUFKIN, TX 75904
(936) 699-5433
(936) 699-5465
Mailing address
203 CHRISTIE ST., LUFKIN, TX 75904
(936) 699-5433
(936) 699-5465

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
J3094
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
123490806
TX
05
179637701
TX
01
BCBS
0066MT
TX
01
J3094
STATE MEDICAL LICENSE
TX
Enumeration date
05/31/2005
Last updated
09/24/2014
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