J. David Evanich, M.D. PA

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

L2878 Issued in TX

Legal business name

J. DAVID EVANICH, M.D. PA

Practice address

1234 FM 407
Ste 100
North Lake, TX 76226

Phone

(972) 420-1776

Fax

(972) 221-8685

NPI assigned

Nov 16, 2011

Last updated

Sep 3, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

John David Evanich, MDNPI 1922056266

Title

President

Phone

(972) 420-1776

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• John David Evanich, M.D.

  • Orthopaedic Surgery Physician
  • Flower Mound, TX
  • NPI 1922056266
  Authorized official Same address or phone

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

{
    "created_epoch": "1321401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630627200000",
    "number": "1194002394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 LONG PRAIRIE RD",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750282783",
            "telephone_number": "972-420-1776",
            "fax_number": "972-221-8685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1234 FM 407",
            "address_2": "STE 100",
            "city": "NORTH LAKE",
            "state": "TX",
            "postal_code": "76226",
            "telephone_number": "972-420-1776",
            "fax_number": "972-221-8685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J. DAVID EVANICH, M.D. PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-16",
        "last_updated": "2021-09-03",
        "certification_date": "2021-08-18",
        "status": "A",
        "authorized_official_last_name": "EVANICH",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "972-420-1776",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "TX",
            "license": "L2878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Orthopaedic Surgery Physician in Northlake, TX
• Providers in Northlake, TX by specialty
• Orthopaedic Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2021; 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.