Provider Demographics
NPI:1124211537
Name:EVANS, KAREN LATOUR (MD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:LATOUR
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:PO BOX 733784
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75373-3784
Mailing Address - Country:US
Mailing Address - Phone:682-885-1855
Mailing Address - Fax:682-885-1396
Practice Address - Street 1:2530 SCRIPTURE ST
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-4317
Practice Address - Country:US
Practice Address - Phone:940-898-1477
Practice Address - Fax:337-769-9460
Is Sole Proprietor?:No
Enumeration Date:2007-08-20
Last Update Date:2021-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA201237208000000X
TXN3818208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1237931Medicaid
LA201237OtherLA STATE LICENCE NUMBER
TX203620409Medicaid
LA201237OtherLA STATE LICENCE NUMBER
TX203620409Medicaid