EVAN GREGORY SMITH (NPI# 1891090577) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891090577 |
| Entity Type | Individual |
| Full Name | EVAN GREGORY SMITH |
| Practice Address |
2200 Bergquist Dr Lackland A F B TX 78236-9907 |
| Mailing Address |
1934 Winding Vw San Antonio TX 78260-7206 |
| Practice Telephone | 2102921990 |
| Enumeration Date | 2011-01-11 |
| Last Update Date | 2013-04-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770112096 | Evan Smith | Nurse Practitioner | 109 Parkway Pl, Tullahoma, TN 37388-5341 | 2020-04-07 |
| 1558854265 | Evan R Smith | Dentist | 99 St Paul Dr, Chambersburg, PA 17201-1020 | 2018-06-08 |
| 1386038065 | Evan Smith | Massage Therapist | 5530 Adams Rd, Talent, OR 97540-7701 | 2015-03-20 |
| 1720376288 | Evan Keith Smith | Dentist | 135 Perrin Pl Ste 100, Charlotte, NC 28207-2356 | 2011-07-19 |
| 1275851867 | Evan Ernest Smith | Specialist | 1314 Ne 8th St, Bend, OR 97701-4469 | 2010-05-06 |
| 1811525553 | Evan Hasani-obadiah Smith | Student in an Organized Health Care Education/Training Program | 3400 Spruce St, Philadelphia, PA 19104-4238 | 2020-03-30 |
| 1891270492 | Evan Conway Smith | Counselor | 33 Nw Broadway, Portland, OR 97209-3580 | 2018-09-28 |
| 1588157010 | Evan Smith | Student in an Organized Health Care Education/Training Program | 3200 Grand Ave, Des Moines, IA 50312-4104 | 2018-06-09 |
| 1376081430 | Evan Robert Smith | Social Worker | 3031 W Ih 10, Attention : Credentialing, San Antonio, TX 78201-5159 | 2017-02-08 |
| 1588119168 | Evan Lee Smith | Psychologist | 325 East Eisenhower, Suite 300, Ann Arbor, MI 48108-5744 | 2016-08-24 |
| Street Address |
2200 BERGQUIST DR |
| City | LACKLAND A F B |
| State | TX |
| Zip Code | 78236-9907 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235139494 | Kathryn Joyce | Nurse Practitioner | 2200 Bergquist Dr, Lackland A F B, TX 78236-9907 | 2005-07-28 |
| 1619219789 | Jodie K Timberlake | Student in an Organized Health Care Education/Training Program | 2200 Bergquist Dr, Willford Hall Ambulatory Surgical Center, Lackland A F B, TX 78236-9907 | 2013-03-26 |
| 1467798884 | James W Parry | Military Health Care Provider | 2200 Bergquist Dr, Lackland A F B, TX 78236-9907 | 2012-12-13 |
| 1093065252 | Brittany Mccright | Physical Therapist | 2200 Bergquist Dr, Lackland A F B, TX 78236-9907 | 2012-09-14 |
| 1003177593 | Danielle Kusserow Bersabe | Internal Medicine | 2200 Bergquist Dr, Wilford Hall Ambulatory Surgical Center, Lackland A F B, TX 78236-9907 | 2012-05-31 |
| 1114206570 | Ana Ugues Aleman | Pharmacist | 2200 Bergquist Dr, Lackland A F B, TX 78236-9907 | 2011-08-16 |
| 1902192743 | Ashley Noelle Franz | Student in an Organized Health Care Education/Training Program | 2200 Bergquist Dr, Wilford Hall Medical Center, Lackland A F B, TX 78236-9907 | 2011-06-20 |
| 1699067694 | Kristen Kann | Emergency Medicine | 2200 Bergquist Dr, Suite 1, Lackland A F B, TX 78236-9907 | 2011-05-09 |
| 1295041853 | Santos Michael Rivera II | Pharmacist | 2200 Bergquist Dr, Lackland A F B, TX 78236-9907 | 2010-08-20 |
| 1245545151 | Corey Dequan Cooper | Pharmacist | 2200 Bergquist Dr, Suite 1, Lackland A F B, TX 78236-9907 | 2010-08-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063047363 | Arnoldo Arturo Gonzalez Jr. | Specialist/Technologist | 1033 Truemper St, Lackland Afb, TX 78236 | 2020-03-06 |
| 1023643343 | Meredith Grace Cockerell | Specialist/Technologist | W Military Drive, San Antonio, TX 78236 | 2020-03-06 |
| 1578120598 | Hali Rashelle Hall | Dentist | 1615 Truemper St, Blg 6418, Attn: 59ds/sgdn, Jbsa Lackland, TX 78236 | 2019-05-24 |
| 1952967077 | Paul Fianza Boseman | Nurse Practitioner | 1106 Wilford Hall Loop, San Antonio, TX 78236 | 2019-05-14 |
| 1689161978 | Kelly Jones Buckshire | Dentist | Dunn Dental Clinic, 1615 Truemper Rd, San Antonio, TX 78236 | 2018-04-23 |
| 1902308570 | Roger Louis Farney | Student in an Organized Health Care Education/Training Program | 1100 Wilford Hall Loop Bldg. 4554, Jbsa Lackland Afb, TX 78236 | 2018-02-28 |
| 1568916856 | Thomas Maxwell Woolf | Dentist | 1100 Wilford Hall Ambulatory Surgical Center, Lackland Afb, TX 78236 | 2016-08-04 |
| 1831544956 | Michael Veronneau | Student in an Organized Health Care Education/Training Program | 59 Mdw/ge 1100 Wilford Hall Loop, Bldg. 4554, Jbsa Lackland, TX 78236 | 2016-04-26 |
| 1376906958 | David Kephart Jr. | General Practice | 1100 Wilford Hall Loop Bldg 4454, Jbsa Lackland, TX 78236 | 2016-04-01 |
| 1184084089 | Olivia Arballo | Dermatology | Wilford Hall Asc, Attn: Dept of Dermatology, 1100 Wilford Hall Loop Bldg 4554, Jbsa-lackland, TX 78236 | 2016-03-04 |
| Find all providers in zip 78236 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831704576 | Leila Olive Adell | Physician Assistant | 1221 S Congress Ave Apt 331, Austin, TX 78704-2461 | 2020-09-10 |
| 1619591864 | Today Telemedicine Pllc | Physician Assistant | 404 Oxford St Apt 2219, Houston, TX 77007-2679 | 2020-06-03 |
| 1497384168 | Gregory C Etienne | Physician Assistant | 7400 N 4th St, Mcallen, TX 78504-1859 | 2020-04-05 |
| 1689202475 | Theodore Inthaphom | Physician Assistant | 25222 Northwest Fwy Apt 349, Cypress, TX 77429-1065 | 2020-03-29 |
| 1740816982 | Alyssa Conrad | Physician Assistant | 4818 Star Jasmine Dr, Austin, TX 78723-6059 | 2020-03-19 |
| 1114558335 | Erin Lynn Brown | Physician Assistant | 1504 Taub Loop Houston, Houston, TX 77030 | 2020-01-27 |
| 1245870930 | Jessica Grimaldo | Physician Assistant | 1200 Brooklyn Ave Ste 230, San Antonio, TX 78212-0010 | 2020-01-09 |
| 1730728528 | Holli Marie Beard | Physician Assistant | 2625 Scripture St Ste 101, Denton, TX 76201-2304 | 2019-12-27 |
| 1477191237 | Ronald Edwin Brown | Physician Assistant | 1427 Cypress Point Dr, Gunter, TX 75058-3201 | 2019-12-11 |
| 1053957910 | Rossalya Aracely Granda Gutierrez | Physician Assistant | 4150 N Collins St, Arlington, TX 76005-4547 | 2019-11-25 |
| Find all providers with the same taxonomy | ||||
| City | LACKLAND A F B |
| Zip Code | 78236 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.