Healthcare Provider Details

I. General information

NPI: 1073409256
Provider Name (Legal Business Name): EVOLVE HEALTH TEXAS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2025
Last Update Date: 10/06/2025
Certification Date: 10/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15200 SOUTHWEST FWY STE 250
SUGAR LAND TX
77478-3865
US

IV. Provider business mailing address

15200 SOUTHWEST FWY STE 250
SUGAR LAND TX
77478-3865
US

V. Phone/Fax

Practice location:
  • Phone: 346-900-0010
  • Fax: 832-375-1247
Mailing address:
  • Phone: 346-900-0010
  • Fax: 832-375-1247

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State

VIII. Authorized Official

Name: ADAM SIEGEL
Title or Position: CRO
Credential: DPM
Phone: 813-549-5678