Individual
EVA S MINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3100 NORTH TARRANT PARKWAY #104, FORT WORTH, TX 76177-8616
(817) 358-5500
(817) 358-5511
Mailing address
479 WESTPARK WAY, EULESS, TX 76040-3957
(817) 358-5500
(817) 358-5511
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
K8344
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
155961901
—
TX
Enumeration date
10/20/2005
Last updated
04/28/2016
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