Provider Demographics
NPI:1003848391
Name:TING, EVELYN CAROL (NP)
Entity Type:Individual
Prefix:MRS
First Name:EVELYN
Middle Name:CAROL
Last Name:TING
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:EVELYN
Other - Middle Name:CAROL
Other - Last Name:EWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:WHCNP
Mailing Address - Street 1:1054 TEXAN TRAIL
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051-3784
Mailing Address - Country:US
Mailing Address - Phone:817-424-2113
Mailing Address - Fax:817-439-6839
Practice Address - Street 1:1054 TEXAN TRAIL
Practice Address - Street 2:SUITE 100
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-3784
Practice Address - Country:US
Practice Address - Phone:817-424-2113
Practice Address - Fax:817-439-6839
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2015-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP107896363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health