Individual
M. BRADLEY EVANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD PA
Contact information
Practice address
324 W MAIN ST, SUITE 100, LEWISVILLE, TX 75057-3866
(972) 420-7212
Mailing address
324 W MAIN ST, SUITE 100, LEWISVILLE, TX 75057-3866
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
M3218
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M3218
MEDICAL LICENSE
TX
Enumeration date
06/08/2006
Last updated
04/21/2014
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