Active NPI
Charlette D Evans, LMT
- Massage Therapist
- Garland, TX
National Provider Identifier
1013574821
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MT124078
- Practice address
- 2940 Broadway Blvd Ste 111
Garland, TX 75041-3731 - Phone
- (469) 994-0694
- NPI assigned
- May 28, 2019
- Last updated
- May 19, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MT124078 | TX | Primary |
Addresses
Primary practice location
2940 Broadway Blvd Ste 111
Garland, TX 75041-3731
Mailing address
4013 N Garland Ave Apt 2
Garland, TX 75040-8557
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MT124078 | TX | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1559001600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1652918400000",
"number": "1013574821",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4013 N GARLAND AVE APT 2",
"city": "GARLAND",
"state": "TX",
"postal_code": "750408557"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2940 BROADWAY BLVD STE 111",
"city": "GARLAND",
"state": "TX",
"postal_code": "750413731",
"telephone_number": "469-994-0694"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVANS",
"first_name": "CHARLETTE",
"middle_name": "D",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-05-28",
"last_updated": "2022-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Massage Therapist",
"state": "TX",
"license": "MT124078",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Garland, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.