Provider Demographics
NPI:1538329404
Name:EVANS, GRANT HOPKINS (DO, FACS)
Entity Type:Individual
Prefix:DR
First Name:GRANT
Middle Name:HOPKINS
Last Name:EVANS
Suffix:
Gender:M
Credentials:DO, FACS
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Mailing Address - Street 1:HEADQUARTERS, US ARMY NORTH
Mailing Address - Street 2:1837 ARMY BLVD ATTN: OCSURG
Mailing Address - City:FORT SAM HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:78234-7800
Mailing Address - Country:US
Mailing Address - Phone:210-221-2603
Mailing Address - Fax:
Practice Address - Street 1:1100 WILFORD HALL LOOP
Practice Address - Street 2:UROLOGY CLINIC
Practice Address - City:LACKLAND AFB
Practice Address - State:TX
Practice Address - Zip Code:78236
Practice Address - Country:US
Practice Address - Phone:210-292-4277
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXS5163208800000X
OK5015208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology