Individual
MR. ZACHARY DEAN BEVANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATP
Contact information
Practice address
100 W ROSEDALE ST, FORT WORTH, TX 76104-4852
(817) 338-4848
(817) 338-4450
Mailing address
100 W ROSEDALE ST, FORT WORTH, TX 76104-4852
(817) 338-4848
(817) 338-4450
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
75719
TX
Other
Enumeration date
02/10/2014
Last updated
02/10/2014
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