Individual
MR. D BRENT EVANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
8607 WURZBACH RD BLDG V, SUITE 201, SAN ANTONIO, TX 78240-1294
(210) 699-9290
(210) 699-9282
Mailing address
8607 WURZBACH RD BLDG V, SUITE 201, SAN ANTONIO, TX 78240-1303
(210) 699-9290
(210) 699-9282
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
341
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00S02D
BLUE CROSS BLUE SHIELD
TX
01
—
2619440
AETNA
TX
01
—
371
LICENSE
TX
01
—
743019457001
CIGNA
TX
01
—
A997786
VALUE OPTIONS
TX
Enumeration date
08/24/2006
Last updated
07/08/2007
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