Provider Demographics
NPI:1972693745
Name:COLBY C EVANS PA
Entity Type:Organization
Organization Name:COLBY C EVANS PA
Other - Org Name:EVANS DERMATOLOGY PARTNERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:COLBY
Authorized Official - Middle Name:C
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-280-3939
Mailing Address - Street 1:9901 BRODIE LN
Mailing Address - Street 2:SUITE 160
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78748-5803
Mailing Address - Country:US
Mailing Address - Phone:512-280-3939
Mailing Address - Fax:
Practice Address - Street 1:9701 BRODIE LANE
Practice Address - Street 2:SUITE A-106
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78748
Practice Address - Country:US
Practice Address - Phone:512-280-3939
Practice Address - Fax:512-280-3938
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL6879207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty