Provider Demographics
NPI:1235843301
Name:EVE CENTER
Entity Type:Organization
Organization Name:EVE CENTER
Other - Org Name:THE EVE CENTER
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PHYSICIAN ASSISTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:CHURCH
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:408-775-1411
Mailing Address - Street 1:701 W 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:CORSICANA
Mailing Address - State:TX
Mailing Address - Zip Code:75110-6359
Mailing Address - Country:US
Mailing Address - Phone:903-257-3677
Mailing Address - Fax:
Practice Address - Street 1:701 W 7TH AVE
Practice Address - Street 2:
Practice Address - City:CORSICANA
Practice Address - State:TX
Practice Address - Zip Code:75110-6359
Practice Address - Country:US
Practice Address - Phone:903-257-3677
Practice Address - Fax:903-257-3676
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-12
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty