Provider Demographics
NPI:1134255706
Name:EVANS, JULIAN L (DC)
Entity type:Individual
Prefix:DR
First Name:JULIAN
Middle Name:L
Last Name:EVANS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16211 CLAY RD
Mailing Address - Street 2:#120
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-5435
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:16211 CLAY RD
Practice Address - Street 2:#120
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-5435
Practice Address - Country:US
Practice Address - Phone:281-856-8560
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8443111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00786RMedicare ID - Type Unspecified