Grant Hopkins Evans, DO, FACS

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

5015 Issued in OK

Practice address

1100 Wilford Hall Loop
Urology Clinic
Lackland AFB, TX 78236

Phone

(210) 292-4277

NPI assigned

Jun 13, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1213315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1538329404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HEADQUARTERS, US ARMY NORTH",
            "address_2": "1837 ARMY BLVD ATTN: OCSURG",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782347800",
            "telephone_number": "210-221-2603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 WILFORD HALL LOOP",
            "address_2": "UROLOGY CLINIC",
            "city": "LACKLAND AFB",
            "state": "TX",
            "postal_code": "78236",
            "telephone_number": "210-292-4277"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3851 Roger Brooke Drive",
            "address_2": "Brooke Army Medical Center",
            "address_purpose": "LOCATION",
            "city": "Fort Sam Houston",
            "state": "TX",
            "postal_code": "78234",
            "country_code": "US",
            "telephone_number": "210-916-0716",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9300 DeWitt Loop",
            "address_purpose": "LOCATION",
            "city": "Fort Belvoir",
            "state": "VA",
            "postal_code": "220605285",
            "country_code": "US",
            "telephone_number": "571-231-2552",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EVANS",
        "first_name": "GRANT",
        "middle_name": "HOPKINS",
        "name_prefix": "Dr.",
        "credential": "DO, FACS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-13",
        "last_updated": "2022-07-21",
        "certification_date": "2020-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "TX",
            "license": "S5163",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "OK",
            "license": "5015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristen Marie Eller, MD
• Laura Marie Elmer, M.D.
• Ricardo Escamilla, M.D.
• Jorge Armando Escudero, RPH
• Charisma Bautista Evangelista, M.D.
• Matthew Thomas Evans
• Beth A. Ewing, CNM, WNNP
• Jeffrey S Fait
• Drew Wayne Fallis Sr., D.D.S
• Anna Zelfond Feldman, M.D.

• Urology Physician in Lackland AFB, TX
• Providers in Lackland AFB, TX by specialty
• Urology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.