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NPI Code Detail

MEDICARE: KIMBERLY R EVANS MD

MEDICARE:   KIMBERLY R EVANS  MD
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
12084P0800XPsychiatry PhysicianT1697TX

General Provider Information

NPI Number : 1417418567
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY R EVANS MD
Provider Business Mailing Address
First Line : 909 NE LOOP 410 STE 600
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78209-1309
Country : US
Telephone Number : 210-460-0070
Fax Number :
Provider Business Practice Location Address
First Line : 909 NE LOOP 410 STE 600
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78209-1309
Country : US
Telephone Number : 210-460-0070
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/29/2019
Last Update Date : 07/07/2023

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Directions to “ KIMBERLY R EVANS MD” Practice Location

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