Provider Demographics
NPI:1740587351
Name:NEVELS, TORRANCE LACHRISTOPHER (PHD, PA-C)
Entity Type:Individual
Prefix:
First Name:TORRANCE
Middle Name:LACHRISTOPHER
Last Name:NEVELS
Suffix:
Gender:M
Credentials:PHD, PA-C
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Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:7554 COPPER CV
Mailing Address - Street 2:
Mailing Address - City:CONVERSE
Mailing Address - State:TX
Mailing Address - Zip Code:78109-3942
Mailing Address - Country:US
Mailing Address - Phone:205-826-5465
Mailing Address - Fax:
Practice Address - Street 1:36065 SANTA FE AVE
Practice Address - Street 2:
Practice Address - City:FORT CAVAZOS
Practice Address - State:TX
Practice Address - Zip Code:76544-5060
Practice Address - Country:US
Practice Address - Phone:254-288-5117
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-16
Last Update Date:2023-08-22
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant