Basic Information
| Provider Information | |||||||||
| NPI: | 1568482255 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | EVANS | ||||||||
| FirstName: | RICK | ||||||||
| MiddleName: | L. | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 740 HOSPITAL DR | ||||||||
| Address2: | SUITE 250 | ||||||||
| City: | BEAUMONT | ||||||||
| State: | TX | ||||||||
| PostalCode: | 777014664 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4902121000 | ||||||||
| FaxNumber: | 4098133302 | ||||||||
| Practice Location | |||||||||
| Address1: | 740 HOSPITAL DR | ||||||||
| Address2: | SUITE 250 | ||||||||
| City: | BEAUMONT | ||||||||
| State: | TX | ||||||||
| PostalCode: | 777014664 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4902121000 | ||||||||
| FaxNumber: | 4098133302 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/19/2006 | ||||||||
| LastUpdateDate: | 10/11/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/11/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | Q3872 | TX | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 346009902 | 05 | TX | MEDICAID | 8911537 | 05 | NC | MEDICAID |