Provider Demographics
NPI:1114181229
Name:EVANS, BETH ANN (DC)
Entity Type:Individual
Prefix:DR
First Name:BETH
Middle Name:ANN
Last Name:EVANS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:617 COUNTY ROAD 5060
Mailing Address - Street 2:
Mailing Address - City:LEONARD
Mailing Address - State:TX
Mailing Address - Zip Code:75452-3905
Mailing Address - Country:US
Mailing Address - Phone:214-771-2942
Mailing Address - Fax:
Practice Address - Street 1:114 S JACKSON AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:WYLIE
Practice Address - State:TX
Practice Address - Zip Code:75098-3938
Practice Address - Country:US
Practice Address - Phone:972-429-4677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-17
Last Update Date:2012-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10929111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor