Active NPI
Justin Aaron Evans, CF-SLP
- Speech-Language Pathologist
- Orange, TX
National Provider Identifier
1104371376
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 112647
- Practice address
- 2363 Twin Oaks
Orange, TX 77630-1367 - Phone
- (409) 670-5991
- NPI assigned
- Aug 17, 2016
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 112647 | TX | Primary |
Addresses
Primary practice location
2363 Twin Oaks
Orange, TX 77630-1367
Mailing address
2363 Twin Oaks
Orange, TX 77630-1367
Phone (409) 670-5991
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 |
|---|---|---|---|
| 112647 | TX | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1471392000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1471392000000",
"number": "1104371376",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2363 TWIN OAKS",
"city": "ORANGE",
"state": "TX",
"postal_code": "776301367",
"telephone_number": "409-670-5991"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2363 TWIN OAKS",
"city": "ORANGE",
"state": "TX",
"postal_code": "776301367",
"telephone_number": "409-670-5991"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVANS",
"first_name": "JUSTIN",
"middle_name": "AARON",
"credential": "CF-SLP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-08-17",
"last_updated": "2016-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "112647",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orange, TX
- East Texas Community Services for the Developmentally Disabled, Inc.
- Samir Sobhy Kamel Ebeade, M.D.,P.A.
- Educare Community Living Corporation - Texas
- Emergency Services of Texas PA
- Carley Kay Erickson, M.S., CCC-SLP
- Peter Shelby Evans, M.D., FACEP
- Evelyn Anderson LPC
- Exceptional H C Orange LLC
- Exceptional Physicians Group Orange PLLC
- Exceptional Port Arthur LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.