Provider Demographics
NPI:1033697198
Name:EVANS, RICHARD D
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:D
Last Name:EVANS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 BELLA ROSE
Mailing Address - Street 2:
Mailing Address - City:BELTON
Mailing Address - State:TX
Mailing Address - Zip Code:76513-0243
Mailing Address - Country:US
Mailing Address - Phone:254-541-0375
Mailing Address - Fax:
Practice Address - Street 1:2723 EXCHANGE PLZ
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76504-7036
Practice Address - Country:US
Practice Address - Phone:254-633-2500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-01
Last Update Date:2018-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator