Provider Demographics
NPI:1205922101
Name:KNAPP, EVAN ALLAN (PSYD)
Entity type:Individual
Prefix:DR
First Name:EVAN
Middle Name:ALLAN
Last Name:KNAPP
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3417 GASTON AVE STE 815
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75246-2034
Mailing Address - Country:US
Mailing Address - Phone:214-824-8878
Mailing Address - Fax:214-291-5949
Practice Address - Street 1:3417 GASTON AVE STE 815
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-2034
Practice Address - Country:US
Practice Address - Phone:214-824-8878
Practice Address - Fax:214-591-5949
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24172103TH0100X, 103TC2200X, 103TC0700X
251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service
No251E00000XAgenciesHome Health
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX098447805Medicaid
TX149565702Medicaid