Active NPI
D Brent Evans, LCSW
- Clinical Social Worker
- San Antonio, TX
National Provider Identifier
1366559312
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 341
- Practice address
- 8607 Wurzbach Rd BLDG V
Suite 201
San Antonio, TX 78240-1294 - Phone
- (210) 699-9290
- Fax
- (210) 699-9282
- NPI assigned
- Aug 24, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 341 | TX | Primary |
Addresses
Primary practice location
8607 Wurzbach Rd BLDG V
Suite 201
San Antonio, TX 78240-1294
Mailing address
8607 Wurzbach Rd BLDG V
Suite 201
San Antonio, TX 78240-1303
Phone (210) 699-9290
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| A997786 | Other | TX | VALUE OPTIONS |
| 00S02D | Other | TX | BLUE CROSS BLUE SHIELD |
| 2619440 | Other | TX | AETNA |
| 743019457001 | Other | TX | CIGNA |
| 371 | Other | TX | LICENSE |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 341 | TX | MD | Clinical Social Worker |
| 371 | TX | MD | Prosthetist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156377600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1366559312",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8607 WURZBACH RD BLDG V",
"address_2": "SUITE 201",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782401303",
"telephone_number": "210-699-9290",
"fax_number": "210-699-9282"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8607 WURZBACH RD BLDG V",
"address_2": "SUITE 201",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782401294",
"telephone_number": "210-699-9290",
"fax_number": "210-699-9282"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVANS",
"first_name": "D",
"middle_name": "BRENT",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "341",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS",
"identifier": "A997786",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "00S02D",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "2619440",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "743019457001",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "371",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.