Active NPI
Terry Ann Eavenson, LMRT
- Radiologic Technologist
- The Woodlands, TX
National Provider Identifier
1720189103
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiologic Technologist
- License
- 200572
- Practice address
- 3115 College Park Dr
Ste 104
The Woodlands, TX 77384-4009 - Phone
- (936) 321-5030
- Fax
- (936) 271-5033
- NPI assigned
- Sep 26, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Radiologic Technologist | 247100000X | 200572 | TX | Primary |
Addresses
Primary practice location
3115 College Park Dr
Ste 104
The Woodlands, TX 77384-4009
Mailing address
11529 Amberwood Dr
Montgomery, TX 77356
Phone (936) 827-8410
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 200572 | TX | MD | Radiologic Technologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Murray B. Fershtman, M.D. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
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- Pediatrics Physician
- Conroe, TX
- NPI 1770669566
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1720189103",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11529 AMBERWOOD DR",
"city": "MONTGOMERY",
"state": "TX",
"postal_code": "77356",
"telephone_number": "936-827-8410"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3115 COLLEGE PARK DR",
"address_2": "STE 104",
"city": "THE WOODLANDS",
"state": "TX",
"postal_code": "773844009",
"telephone_number": "936-321-5030",
"fax_number": "936-271-5033"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EAVENSON",
"first_name": "TERRY",
"middle_name": "ANN",
"name_prefix": "Ms.",
"credential": "LMRT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "247100000X",
"taxonomy_group": "",
"desc": "Radiologic Technologist",
"state": "TX",
"license": "200572",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in The Woodlands, 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.