Provider Demographics
NPI:1205092988
Name:EVERI WOMAN'S HEALTH CARE, P.A.
Entity type:Organization
Organization Name:EVERI WOMAN'S HEALTH CARE, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:A
Authorized Official - Last Name:EVERING-SIMMS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:903-935-2911
Mailing Address - Street 1:707 S GROVE ST
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:TX
Mailing Address - Zip Code:75670-5220
Mailing Address - Country:US
Mailing Address - Phone:903-935-2911
Mailing Address - Fax:903-935-7217
Practice Address - Street 1:707 S GROVE ST
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:TX
Practice Address - Zip Code:75670-5220
Practice Address - Country:US
Practice Address - Phone:903-935-2911
Practice Address - Fax:903-935-7217
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-01
Last Update Date:2008-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ5317207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0993180-02Medicaid