Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 2141322 | TX |
NPI | 1013498666 |
---|---|
Provider Name | Curtis Evans |
First Address | Plano, TX 75024-4252 |
Second Address | Kilgore, TX 75662-4033 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2018 |
Last Update Date | 22/08/2018 |