Individual provider Active NPI

Justin Brady Evans, M.D.

  • Emergency Medicine Physician
  • Dallas, TX
National Provider Identifier
1538692520
Registry record updated Jun 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
S0873 Issued in TX
Practice address
5323 Harry Hines Blvd
Dallas, TX 75390-7201
Phone
(214) 648-3111
NPI assigned
Apr 6, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X S0873 TX Primary

Addresses

Primary practice location

5323 Harry Hines Blvd
Dallas, TX 75390-7201

Mailing address

5014 Chambers St Apt 1058B
Dallas, TX 75206-8680

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200505000667 TX Practitioner - Emergency Medicine 5890126981 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Alabama School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Medicine Resources, LLPGroup PAC ID 5890688212, 255 clinicians

Practice addresses (Care Compare)

6200 W Parker Rd
Plano, TX 75093-8185
Phone (972) 981-8000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Medicine Resources, LLP Emergency Medicine CurrentSince Jul 1, 2020 Accepting new patients
Texas Physician Resources, LLP Emergency Medicine CurrentSince Jul 1, 2020 Accepting new patients
Pediatric Emergency Medicine Group LLP Emergency Medicine CurrentSince Jul 1, 2020 Accepting new patients

Locations

1105 Central Expy N
Allen, TX 75013
Phone (972) 747-4313

8200 Walnut Hill Ln
Dallas, TX 75231
Phone (214) 345-6148

1441 N Beckley Ave
Dallas, TX 75203
Phone (214) 712-2429

1301 Pennsylvania Ave
Ft Worth, TX 76104
Phone (817) 250-2000

2700 E Broad St
Mansfield, TX 76063
Phone (682) 242-2000

7601 Preston Rd
Plano, TX 75024
Phone (469) 303-7300

6200 W Parker Rd
Plano, TX 75093
Phone (972) 608-8000

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1491436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593388800000",
    "number": "1538692520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5014 CHAMBERS ST APT 1058B",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752068680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5323 HARRY HINES BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753907201",
            "telephone_number": "214-648-3111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "JUSTIN",
        "middle_name": "BRADY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-06",
        "last_updated": "2020-06-29",
        "certification_date": "2020-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "S0873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.