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Dr. Evan L Cohn

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NPI Number Detailed Information

Provider Information:

Name: Dr. Evan L Cohn
Gender: M
Provider License Number If Given: K5084

NPI Information:

NPI: 1104825488
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 7/19/2005

Last Update Date: 11/19/2014

Provider Business Mailing Address:

Address: 816 W CANNON ST
Fort Worth, TX 76104
Phone Number: 2143638378
Fax Number: 2143630720

Provider Business Practice Location Address:

Address: 815 PENNSYLVANIA AVE SUITE 710
Fort Worth, TX 76104
Phone Number: 8173210387
Fax Number: 2143630720

Provider Taxonomy:

Primary: 2085R0202X
Secondary (if any):
State: TX

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