J. David Evanich, M.D. PA

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

Legal business name

J. DAVID EVANICH, M.D. PA

Practice address

5000 Long Prairie Rd
Flower Mound, TX 75028-2783

Phone

(972) 420-1776

Fax

(972) 436-6996

NPI assigned

Oct 26, 2006

Organization subpart

No

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

Authorized official

Name

J. David Evanich, M.D.

Title

Owner

Phone

(972) 420-1776

Specialties & licenses 1

Addresses

Other identifiers 3

Electronic endpoints 1

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634083200000",
    "number": "1700961075",
    "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": "972-436-6996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 LONG PRAIRIE RD",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750282783",
            "telephone_number": "972-420-1776",
            "fax_number": "972-436-6996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J. DAVID EVANICH, M.D. PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2021-10-13",
        "certification_date": "2021-10-13",
        "status": "A",
        "authorized_official_last_name": "EVANICH",
        "authorized_official_first_name": "J.",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "972-420-1776",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DN8474",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "170524601",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS",
            "identifier": "0009PZ",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://orthopedicassociates.org/",
            "affiliation": "N",
            "endpointDescription": "Website",
            "address_1": "5000 Long Prairie Rd Ste 100",
            "city": "Flower Mound",
            "state": "TX",
            "country_code": "US",
            "postal_code": "750282783",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Orthopaedic Surgery Physician in Flower Mound, TX
• Providers in Flower Mound, 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 Oct 13, 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.