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NPI Code Detail

MEDICARE: KELCI S EVANS P.A.

MEDICARE:   KELCI S EVANS  P.A.
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
1363A00000XPhysician Assistant1107267TX

General Provider Information

NPI Number : 1205172665
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELCI S EVANS P.A.
Provider Business Mailing Address
First Line : 300 NORTHPARK DR STE 100
Second Line :
City : KINGWOOD
State : TX
Zip : 77339-2695
Country : US
Telephone Number : 281-310-8445
Fax Number : 281-356-1978
Provider Business Practice Location Address
First Line : 300 NORTHPARK DR
Second Line :
City : KINGWOOD
State : TX
Zip : 77339-1672
Country : US
Telephone Number : 281-310-8445
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/12/2012
Last Update Date : 01/26/2024

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Directions to “ KELCI S EVANS P.A.” Practice Location

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