Provider Demographics
NPI:1407917859
Name:EVANS, JOE V (DC)
Entity Type:Individual
Prefix:
First Name:JOE
Middle Name:V
Last Name:EVANS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2212 N BEACH ST
Mailing Address - Street 2:
Mailing Address - City:HALTOM CITY
Mailing Address - State:TX
Mailing Address - Zip Code:76111-6813
Mailing Address - Country:US
Mailing Address - Phone:817-222-0697
Mailing Address - Fax:817-222-0699
Practice Address - Street 1:2212 N BEACH ST
Practice Address - Street 2:
Practice Address - City:HALTOM CITY
Practice Address - State:TX
Practice Address - Zip Code:76111-6813
Practice Address - Country:US
Practice Address - Phone:817-222-0697
Practice Address - Fax:817-222-0699
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9105111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor