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DR. ETHAN SAMUEL EVANS MD
NPI 1053053629
Student in an Organized Health Care Education/Training Program in Bryan, TX

Active since April 12, 2022PECOS Enrolled
2900 E 29TH ST STE 300, BRYAN, TX 77802(972) 436-9162 Get Directions Write a Review

NPPES record last updated: April 12, 2022. Verified against the NPPES registry weekly; last sync: September 06, 2026.

About Dr. Ethan Samuel Evans Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. ETHAN SAMUEL EVANS MD (NPI 1053053629) is an individual student in an organized health care education/training program in Bryan, Texas and active in the NPI registry since April 2022. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1053053629
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameDR. ETHAN SAMUEL EVANSCredential: MD
Location Address2900 E 29TH ST STE 300Bryan, TX 77802-2623
Mailing Address2900 E 29th St Ste 300Bryan, TX 77802-2623 · (972) 436-9162
Phone(972) 436-9162
Sole ProprietorYes
Enumeration DateApril 12, 2022
NPPES CertifiedApril 12, 2022
✔ NPI 1053053629 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
2900 E 29TH ST STE 300, Bryan, TX 77802
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Ethan Samuel Evans Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MACKENZIE ZUMWALT LPC
Counselor (Professional)
2900 E 29TH ST STE 300
BRYAN, TX 77802
Brazos County (979) 436-0810
ANDREW Z WANG
Student in an Organized Health Care Education/Training Program
2900 E 29TH ST STE 300
BRYAN, TX 77802
Brazos County (979) 774-8200
DR. RODNEY KIPRUTO BOIT MD
Student in an Organized Health Care Education/Training Program
2900 E 29TH ST STE 300
BRYAN, TX 77802
Brazos County (806) 367-1503
DR. EVA PATRICE JOHNSON MD
Psychiatry & Neurology (Psychiatry)
2900 E 29TH ST STE 300
BRYAN, TX 77802
Brazos County (979) 774-8200
ARIEL PETRANEK
Student in an Organized Health Care Education/Training Program
2900 E 29TH ST STE 300
BRYAN, TX 77802
Brazos County (979) 436-9162
LISSETTE PALACIOS MA, LPC- ASSOCIATE
Counselor (Professional)
2900 E 29TH ST STE 300
BRYAN, TX 77802
Brazos County (979) 436-0125
DR. SARAH HUE CHAU DO
Student in an Organized Health Care Education/Training Program
2900 E 29TH ST STE 300
BRYAN, TX 77802
Brazos County (979) 774-8200
MRS. LILIAN ZHAN DO
Student in an Organized Health Care Education/Training Program
2900 E 29TH ST STE 300
BRYAN, TX 77802
Brazos County (979) 776-8440

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ethan Evans's NPI number?

The NPI number for Ethan Evans is 1053053629. It was assigned to this individual provider in the NPPES registry on April 12, 2022.

Where is Ethan Evans located?

Ethan Evans practices at 2900 E 29th St Ste 300, Bryan, TX 77802. The listed phone number is (972) 436-9162.

What is Ethan Evans's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Ethan Evans enrolled in Medicare?

Yes. Ethan Evans is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Ethan Evans was last updated on April 12, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.