Blackwell, Evan

Blackwell, Evan is an individual health care provider with primary practice located at 2911 A W Grimes Blvd Ste 106 , Pflugerville TX 78660-5459. He recently has 3 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / Periodontics, Student, Health Care / Student in an Organized Health Care Education/Training Program. Dental Providers / Periodontics is his primary health care specialty. Blackwell, Evan can be contacted via phone (512) 337-2578.

Contact Information

Primary practice address
2911 A W Grimes Blvd Ste 106 Pflugerville TX 78660-5459
Phone: (512) 337-2578
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 32883 Texas
Dental Providers / Dentist 122300000X D10343 Oregon
Dental Providers / Periodontics 1223P0300X 32883 Texas
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X

Profile Details

NPI number 1588072987
LBN Legal business name Blackwell, Evan
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 29th, 2014
Last updated Jul 27th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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