Provider Demographics
NPI:1114092871
Name:SHEARER, EVELYN VIRGINIA
Entity Type:Individual
Prefix:DR
First Name:EVELYN
Middle Name:VIRGINIA
Last Name:SHEARER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:EVELYN
Other - Middle Name:
Other - Last Name:SHEARER-POOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3600 GASTON AVE
Mailing Address - Street 2:WADLEY TOWER STE 962
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75246-1800
Mailing Address - Country:US
Mailing Address - Phone:713-818-8386
Mailing Address - Fax:
Practice Address - Street 1:2300 MARIE CURIE DR
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75042-5706
Practice Address - Country:US
Practice Address - Phone:713-818-8386
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ3218207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXJ3218OtherTEXAS STATE PERMIT
ORMD28144OtherOREGON STATE PERMIT
TX1285157-07Medicaid
NMMD2008-0719OtherNEW MEXICO STATE PERMIT
WAMD00046604OtherWASHINGTON STATE PERMIT
TXT0083311OtherDPS
TX128515702Medicaid
NC33561OtherNORTH CAROLINA STATE PERMIT
TXBS1836672OtherDEA
TXT0083311OtherDPS
NC33561OtherNORTH CAROLINA STATE PERMIT
TXJ3218OtherTEXAS STATE PERMIT