Provider Demographics
NPI:1942227574
Name:EVANS, PETER SHELBY (MD, FACEP)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:SHELBY
Last Name:EVANS
Suffix:
Gender:M
Credentials:MD, FACEP
Other - Prefix:
Other - First Name:P. SHELBY
Other - Middle Name:
Other - Last Name:EVANS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:11431 LAKESIDE PLACE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077-3236
Mailing Address - Country:US
Mailing Address - Phone:281-759-5927
Mailing Address - Fax:
Practice Address - Street 1:7600 BEECHNUT ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-4302
Practice Address - Country:US
Practice Address - Phone:713-456-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA49953207P00000X
TXK8139207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine