Individual
TRACIE LYNN EVANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6201 BONHOMME RD STE 288N, HOUSTON, TX 77036-4493
(832) 453-4918
Mailing address
6201 BONHOMME RD STE 288N, HOUSTON, TX 77036-4493
(832) 453-4918
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
171MOOOOOOX
—
TX
Enumeration date
11/18/2019
Last updated
11/18/2019
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