Individual
DR. LARRY W EVANS
Active
Individual
DR. LARRY W EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
H6203
TX
207LP2900X
Pain Medicine (Anesthesiology) Physician
H6203
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
134049911
—
TX
01
—
152248403
EPSDT
TX
01
—
5683525
AETNA
TX
01
—
752616977065
TRICARE CHAMPUS
TX
01
—
EV08J0375
BCBS
TX
01
—
P00253558
MEDICARE RAILROAD
TX
Enumeration date
02/13/2006
Last updated
04/30/2015
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