Organization
J. DAVID EVANICH, M.D. PA
Active
Organization
J. DAVID EVANICH, M.D. PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
J. DAVID EVANICH M.D. (OWNER)
(972) 420-1776
Entity
Organization
Contact information
Practice address
5000 LONG PRAIRIE RD, FLOWER MOUND, TX 75028-2783
(972) 420-1776
(972) 436-6996
Mailing address
5000 LONG PRAIRIE RD, FLOWER MOUND, TX 75028-2783
(972) 420-1776
(972) 436-6996
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0009PZ
BLUECROSS
TX
05
—
170524601
—
TX
01
—
DN8474
RAILROAD MEDICARE
TX
Enumeration date
10/26/2006
Last updated
10/13/2021
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