Provider Demographics
NPI:1518527126
Name:EVANS, ASHLEY RENEA (PA-C)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:RENEA
Last Name:EVANS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:607 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FARMERSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75442-1611
Mailing Address - Country:US
Mailing Address - Phone:936-366-4030
Mailing Address - Fax:
Practice Address - Street 1:9101 N CENTRAL EXPY STE 370
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-5947
Practice Address - Country:US
Practice Address - Phone:214-820-8220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-17
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA12934363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant