Healthcare Provider Details

I. General information

NPI: 1487857660
Provider Name (Legal Business Name): TIMOTHY PATRICK MCEVOY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: TIMOTHY P. MCEVOY MD

II. Dates (important events)

Enumeration Date: 06/06/2007
Last Update Date: 08/14/2023
Certification Date: 08/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 OAK CENTRE DR STE 350
SAN ANTONIO TX
78258-3945
US

IV. Provider business mailing address

525 OAK CENTRE DR STE 350
SAN ANTONIO TX
78258-3945
US

V. Phone/Fax

Practice location:
  • Phone: 210-890-5444
  • Fax: 210-593-3099
Mailing address:
  • Phone: 210-890-5444
  • Fax: 210-593-3099

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberP6677
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207YP0228X
TaxonomyPediatric Otolaryngology Physician
License NumberP6677
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: