MEDICARE: JOHN R. EVERETT

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	332S00000X	Hearing Aid Equipment

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	6274096	OTHER	TX	CIGNA
3	516541	OTHER	TX	BLUE CROSS BLUE SHIELD
4	2931013	OTHER	TX	AETNA

General Provider Information

NPI Number	:	1932244217
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOHN R. EVERETT

Provider Business Mailing Address
First Line	:	1121 DALLAS DR
Second Line	:	SUITE 6
City	:	DENTON
State	:	TX
Zip	:	76205-5100
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1121 DALLAS DR
Second Line	:	SUITE 6
City	:	DENTON
State	:	TX
Zip	:	76205-5100
Country	:	US
Telephone Number	:	940-387-2195
Fax Number	:	940-565-5973

Authorized Official
Title or Position	:	SECRETARY
Name	:	MARGIT E WALLACE
Credential	:
Telephone Number	:	940-387-2195

Provider Enumeration Date	:	02/21/2007
Last Update Date	:	06/12/2008

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Directions to “JOHN R. EVERETT ” Practice Location

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