Healthcare Provider Details

I. General information

NPI: 1629547484
Provider Name (Legal Business Name): PATRICK EVANS PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2018
Last Update Date: 06/13/2025
Certification Date: 06/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 E PFLUGERVILLE PKWY STE 1102
PFLUGERVILLE TX
78660-6148
US

IV. Provider business mailing address

PO BOX 746768
ATLANTA GA
30374-6768
US

V. Phone/Fax

Practice location:
  • Phone: 512-252-3700
  • Fax:
Mailing address:
  • Phone: 512-359-7546
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA12524
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: