Provider Demographics
NPI:1306012356
Name:EVANS, TANYA H (MD)
Entity Type:Individual
Prefix:DR
First Name:TANYA
Middle Name:H
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 35629
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75235-0629
Mailing Address - Country:US
Mailing Address - Phone:214-424-2213
Mailing Address - Fax:214-231-2159
Practice Address - Street 1:5236 W UNIVERSITY DR STE 3300
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-8121
Practice Address - Country:US
Practice Address - Phone:972-562-4430
Practice Address - Fax:817-424-3491
Is Sole Proprietor?:No
Enumeration Date:2008-04-30
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM9269207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXM9269OtherMEDICAL LICENSE
TX8DH915OtherBCBSTX
TX199468302Medicaid
TXM9269OtherMEDICAL LICENSE