MEDICARE: EVVDC, PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor
2	363LF0000X	Family Nurse Practitioner

General Provider Information

NPI Number	:	1083801211
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EVVDC, PC

Provider Business Mailing Address
First Line	:	4001 MCEWEN RD STE 100
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75244-5021
Country	:	US
Telephone Number	:	214-295-9671
Fax Number	:	972-432-5139

Provider Business Practice Location Address
First Line	:	4001 MCEWEN RD STE 100
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75244-5021
Country	:	US
Telephone Number	:	214-295-9671
Fax Number	:	972-432-5139

Authorized Official
Title or Position	:	OWNER
Name	:	MELINDA ERIN VANVELDHUIZEN
Credential	:	DC, FNP
Telephone Number	:	214-295-9671

Provider Enumeration Date	:	10/02/2007
Last Update Date	:	08/08/2019

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