Healthcare Provider Details

I. General information

NPI: 1497722953
Provider Name (Legal Business Name): WILLIAM M EVANS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/03/2006
Last Update Date: 11/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 CEDAR BEND DR.
AUSTIN TX
78758-2483
US

IV. Provider business mailing address

12221 MOPAC EXPRESSWAY NORTH
AUSTIN TX
78758-2483
US

V. Phone/Fax

Practice location:
  • Phone: 512-901-4031
  • Fax: 512-901-3937
Mailing address:
  • Phone: 512-901-4031
  • Fax: 512-901-3937

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberH3460
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: