Provider Demographics
NPI:1598747750
Name:EVANS, WALTER F II (M D)
Entity Type:Individual
Prefix:DR
First Name:WALTER
Middle Name:F
Last Name:EVANS
Suffix:II
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8160 WALNUT HILL LN
Mailing Address - Street 2:SUITE 214, LOCKBOX 40
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-4339
Mailing Address - Country:US
Mailing Address - Phone:214-739-1300
Mailing Address - Fax:214-739-0622
Practice Address - Street 1:8160 WALNUT HILL LN
Practice Address - Street 2:SUITE 214, LOCKBOX 40
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4339
Practice Address - Country:US
Practice Address - Phone:214-739-1300
Practice Address - Fax:214-739-0622
Is Sole Proprietor?:No
Enumeration Date:2005-11-15
Last Update Date:2014-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF5533207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1237588Medicaid
TX1237588Medicaid
8900B0Medicare ID - Type UnspecifiedMEDICARE PROVIDER ID