Evangelina Baustista

Primary specialty

Licensed Vocational NurseTaxonomy code 164X00000X

License

119696 Issued in TX

Practice address

1314 Lake St
Fort Worth, TX 76102-4581

Phone

(903) 532-1400

NPI assigned

Aug 7, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1533600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533600000000",
    "number": "1033698402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "824 WHITE ROCK ST",
            "city": "SAGINAW",
            "state": "TX",
            "postal_code": "761793430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1314 LAKE ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761024581",
            "telephone_number": "903-532-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUSTISTA",
        "first_name": "EVANGELINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-07",
        "last_updated": "2018-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "TX",
            "license": "119696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pallavi Kiran Batwar, M.D
• Michael Baum, MA, ATC, PES
• Taylor Ann Bauman, PT, DPT
• Joane Baumer, M.D.
• Jeff Baures, D.C.
• Hanna Bautista, RBT
• Juan Moises Bautista, LPC A
• Sierra Martha Wilson Bautista
• Egle Bavry, MD
• Gurpreet S Baweja, MD

• All providers in Fort Worth, TX
• Licensed Vocational Nurse in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.