Individual
KIM A. EVERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
12222 MERIT DR STE 600, DALLAS, TX 75251-3294
(972) 715-5000
(972) 715-9976
Mailing address
PO BOX 840853, DALLAS, TX 75284-0853
(972) 233-1999
(972) 233-3666
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
500207
TX
367500000X
Certified Registered Nurse Anesthetist
Primary
AP111085
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
154320907
—
TX
05
—
154320908
—
TX
05
—
154320909
—
TX
01
—
85197U
BLUE CROSS
TX
01
—
8872UG
BCBS
TX
01
—
89606U
BCBS
TX
01
—
P00983532
RAILROAD
TX
01
—
P01445787
RR
TX
Enumeration date
02/02/2006
Last updated
06/23/2022
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