Provider Demographics
NPI:1003072604
Name:EVANSON, J RICHARD LEE (DO)
Entity type:Individual
Prefix:DR
First Name:J RICHARD
Middle Name:LEE
Last Name:EVANSON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:5228 W PLANO PKWY
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093
Mailing Address - Country:US
Mailing Address - Phone:972-250-5700
Mailing Address - Fax:469-281-2459
Practice Address - Street 1:5228 W PLANO PKWY
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093
Practice Address - Country:US
Practice Address - Phone:972-250-5700
Practice Address - Fax:469-281-2459
Is Sole Proprietor?:No
Enumeration Date:2008-08-03
Last Update Date:2025-08-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA63653207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAVAD 000Medicare UPIN