Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0402X | Child Neurologist | G4867 | TX |
NPI | 1316956626 |
---|---|
Provider Name | Dr. Patricia Ann Evans |
First Address | Dallas, TX 75390-9063 |
Second Address | Dallas, TX 75207 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2006 |
Last Update Date | 06/12/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
136675910 | (05) | TX |
F55418 | (02) |