Healthcare Provider Details

I. General information

NPI: 1780598086
Provider Name (Legal Business Name): EVERVITA PHYSICIAN SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5945 DALLAS PKWY
PLANO TX
75093-7878
US

IV. Provider business mailing address

5945 DALLAS PKWY
PLANO TX
75093-7878
US

V. Phone/Fax

Practice location:
  • Phone: 469-544-0118
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: UZAIR SHAHNAWAZ
Title or Position: CEO
Credential:
Phone: 469-544-0118