Individual
CAROL MARIE EVERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4055 VALLEY VIEW LN STE 400, DALLAS, TX 75244-5071
(855) 984-5121
Mailing address
4055 VALLEY VIEW LN, STE 700, DALLAS, TX, DALLAS, TX 75244
(304) 457-0063
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
1344
WV
363A00000X
Physician Assistant
007049
GA
363A00000X
Physician Assistant
Primary
1344
WV
363A00000X
Physician Assistant
415
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810013903
—
WV
Enumeration date
05/07/2008
Last updated
07/09/2026
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