Active NPI
Evan James Davis
- Pharmacist
- Irving, TX
National Provider Identifier
1790388874
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 65769
- Practice address
- 1635 Market PL
Irving, TX 75063-7239 - Phone
- (214) 574-4517
- NPI assigned
- Nov 19, 2020
- Last updated
- Nov 19, 2020
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 65769 | TX | Primary |
Addresses
Primary practice location
1635 Market PL
Irving, TX 75063-7239
Mailing address
300 E Round Grove Rd Apt 227
Lewisville, TX 75067-3831
Phone (817) 455-5359
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 |
|---|---|---|---|
| 65769 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1605744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605744000000",
"number": "1790388874",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 E ROUND GROVE RD APT 227",
"city": "LEWISVILLE",
"state": "TX",
"postal_code": "750673831",
"telephone_number": "817-455-5359"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1635 MARKET PL",
"city": "IRVING",
"state": "TX",
"postal_code": "750637239",
"telephone_number": "214-574-4517"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "EVAN",
"middle_name": "JAMES",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-11-19",
"last_updated": "2020-11-19",
"certification_date": "2020-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "65769",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Irving, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.