Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | P2236 | TX |
Y | 207XS0117X | Orthopaedic Spine Surgeon | P2236 | TX |
NPI | 1215084033 |
---|---|
Provider Name | Jesse Even |
First Address | Arlington, TX 76015-3604 |
Second Address | Arlington, TX 76015-3604 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2007 |
Last Update Date | 12/06/2015 |