Provider Demographics
NPI:1316956626
Name:EVANS, PATRICIA ANN (MD)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:ANN
Last Name:EVANS
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 1:5323 HARRY HINES BLVD.
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75390-9063
Mailing Address - Country:US
Mailing Address - Phone:214-456-2768
Mailing Address - Fax:214-456-6898
Practice Address - Street 1:2350 STEMMONS FREEWAY
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75207
Practice Address - Country:US
Practice Address - Phone:214-456-2768
Practice Address - Fax:214-456-6898
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2010-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG48672084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX136675910Medicaid
TX136675910Medicaid
F55418Medicare UPIN