Individual ProviderEvan BradshawStudent in an Organized Health Care Education/Training ProgramStudent, Health CarePractice Address3601 4th Street, Department Of Orthopaedic Surgery, Ms 9436, Lubbock, TX 79430(806) 743-2465PECOS EnrollmentBased on the most recent information from CMS, provider Evan Bradshaw does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 4 days ago.Profile DetailsProvider ID1962250506Provider TypeIndividualFull NameBradshaw, EvanCredentialMDGenderMaleSole ProprietorNoEnumeration Date5/8/2024Last Updated5/9/2024Contact InformationPractice LocationPractice Address3601 4th Street, Department Of Orthopaedic Surgery, Ms 9436, Lubbock, TX 79430Phone(806) 743-2465FaxUnlisted FaxMailing LocationMailing Address3601 4th Street, Department Of Orthopaedic Surgery, Ms 9436, Lubbock, TX 79430PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode390200000XPrimaryDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicense786025Texas