Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 0101246779 | VA |
N | 207YX0905X | Otolaryngology/Facial Plastic Surgery | MD440336 | PA |
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | P0825 | TX |
NPI | 1083825467 |
---|---|
Provider Name | Seth H Evans |
First Address | Kyle, TX 78640-6179 |
Second Address | Kyle, TX 78640-6179 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2007 |
Last Update Date | 21/04/2015 |