Provider Demographics
NPI:1982782900
Name:EVANS, RICHARD A (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:A
Last Name:EVANS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1011 AUGUSTA DR.
Mailing Address - Street 2:SUITE 210
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-2061
Mailing Address - Country:US
Mailing Address - Phone:713-975-6270
Mailing Address - Fax:713-977-2716
Practice Address - Street 1:1011 AUGUSTA DR.
Practice Address - Street 2:SUITE 210
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-2061
Practice Address - Country:US
Practice Address - Phone:713-975-6270
Practice Address - Fax:713-977-2716
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE38162081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
C15530Medicare UPIN
TXC15530Medicare UPIN
TX00T458Medicare PIN