Provider Demographics
NPI:1164484689
Name:MCEVERS, JIM LAWRENCE (PA - C)
Entity Type:Individual
Prefix:MR
First Name:JIM
Middle Name:LAWRENCE
Last Name:MCEVERS
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Gender:M
Credentials:PA - C
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Mailing Address - Street 1:1046 GARDEN OAKS ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:TX
Mailing Address - Zip Code:78934-1689
Mailing Address - Country:US
Mailing Address - Phone:979-732-3078
Mailing Address - Fax:979-732-5795
Practice Address - Street 1:109 SHULT DR
Practice Address - Street 2:SUITE 101
Practice Address - City:COLUMBUS
Practice Address - State:TX
Practice Address - Zip Code:78934-3015
Practice Address - Country:US
Practice Address - Phone:979-732-5794
Practice Address - Fax:979-732-5795
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-03
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXPA 00856363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical