MEDICARE: DR. DENNIS JON EVANS D.C.

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	111NS0005X	Sports Physician Chiropractor	7840	TX

General Provider Information

NPI Number	:	1790019883
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DENNIS JON EVANS D.C.

Provider Business Mailing Address
First Line	:	6300 WEST LOOP S STE 560
Second Line	:
City	:	BELLAIRE
State	:	TX
Zip	:	77401-2903
Country	:	US
Telephone Number	:	713-572-4100
Fax Number	:	713-665-2299

Provider Business Practice Location Address
First Line	:	6300 WEST LOOP S STE 560
Second Line	:
City	:	BELLAIRE
State	:	TX
Zip	:	77401-2903
Country	:	US
Telephone Number	:	713-572-4100
Fax Number	:	713-665-2299

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/23/2009
Last Update Date	:	09/23/2009

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