Individual
EDMOND C EVANS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
400 SW 25TH AVE, MINERAL WELLS, TX 76067-8246
(940) 325-7891
(940) 328-6523
Mailing address
400 SW 25TH AVE, MINERAL WELLS, TX 76067-8246
(940) 325-7891
(940) 328-6523
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
D4484
TX
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
D4484
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
033822002
—
TX
01
—
8U9490
BCBS
TX
Enumeration date
06/28/2006
Last updated
04/28/2017
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