Provider Demographics
NPI:1952338113
Name:COLLINS, EVAN (MD)
Entity Type:Individual
Prefix:
First Name:EVAN
Middle Name:
Last Name:COLLINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6550 FANNIN ST
Mailing Address - Street 2:SUITE 2600
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2717
Mailing Address - Country:US
Mailing Address - Phone:713-441-9000
Mailing Address - Fax:
Practice Address - Street 1:6550 FANNIN ST
Practice Address - Street 2:SUITE 2600
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2717
Practice Address - Country:US
Practice Address - Phone:713-441-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2014-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK3138207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX116172106Medicaid
TX610197300OtherUS DEPT OF LABOR
601771109OtherUS DEPT OF LABOR
TXP00252560OtherMEDICARE RAILROAD
TXP01321615OtherRR MEDICARE
616771105OtherUS DEPT OF LABOR
TXP01070463OtherRR MEDICARE
616771110OtherUS DEPT OF LABOR
616771101OtherUS DEPT OF LABOR
TX8S9715OtherBLUE CROSS BLUE SHIELD
TX610197300OtherUS DEPT OF LABOR
TX116172106Medicaid
TX309523YMVQMedicare PIN
TXP01321615OtherRR MEDICARE
TX8S9715OtherBLUE CROSS BLUE SHIELD
TXTXB151140Medicare PIN
TX8D8822Medicare PIN