Provider Demographics
NPI:1619522315
Name:EVERCARE FAMILY CLINIC PLLC
Entity Type:Organization
Organization Name:EVERCARE FAMILY CLINIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:ISRAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:VACARCEL
Authorized Official - Suffix:
Authorized Official - Credentials:APRN-FNP-C
Authorized Official - Phone:832-335-8410
Mailing Address - Street 1:1417 FM 1463 RD STE 120
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-5456
Mailing Address - Country:US
Mailing Address - Phone:713-429-5051
Mailing Address - Fax:
Practice Address - Street 1:1417 FM 1463 RD STE 120
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-5456
Practice Address - Country:US
Practice Address - Phone:713-429-5051
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-08
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1205391232OtherNPI