Individual
DR. EVAN M EVANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
H6201
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000527435
BS KY PROVIDER #
KY
05
—
103066004
—
TX
05
—
103066008
—
TX
05
—
103066009
—
TX
05
—
7100015000
—
KY
01
—
750818167013
TRICARE MFH/ROSS BREAST CENTER
TX
01
—
752616977007
TRICARE TRINITY CLINIC
TX
01
—
752616977113
TRICARE
TX
01
—
8B0529
BCBS MFH/ROSS BREAST CENTER
TX
01
—
8CU198
BCBS MFH-JV-RBC LOCATION
TX
01
—
8M8275
BCBS TRINITY CLINIC
TX
01
—
TIN PLUS 005
TRICARE MFH-JV-RBC LOCATION
TX
Enumeration date
02/13/2006
Last updated
06/19/2023
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