Provider Demographics
NPI:1124033964
Name:CAYTON, EVANGELINE TAJONERA (MD)
Entity type:Individual
Prefix:
First Name:EVANGELINE
Middle Name:TAJONERA
Last Name:CAYTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 N WASHINGTON AVE
Mailing Address - Street 2:SUITE 4000
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75246-1713
Mailing Address - Country:US
Mailing Address - Phone:214-820-1981
Mailing Address - Fax:214-820-1654
Practice Address - Street 1:411 N WASHINGTON AVE
Practice Address - Street 2:SUITE 4000
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-1713
Practice Address - Country:US
Practice Address - Phone:214-820-1981
Practice Address - Fax:214-820-1654
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2009-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXC14322208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1358186-06Medicaid
TX8BR091OtherBCBS
TX1358186-08Medicaid
TX135818609Medicaid
TX89Z146Medicare PIN
TX8BR091OtherBCBS
TX1358186-06Medicaid
TX1358186-08Medicaid
TX89X633Medicare PIN