Healthcare Provider Details

I. General information

NPI: 1902235310
Provider Name (Legal Business Name): LILA EVANS STEVENS FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2013
Last Update Date: 10/05/2023
Certification Date: 10/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11355 US HIGHWAY 87 S UNIT 2
ADKINS TX
78101-1851
US

IV. Provider business mailing address

1746 W GOODWIN ST
PLEASANTON TX
78064-4500
US

V. Phone/Fax

Practice location:
  • Phone: 210-201-4327
  • Fax:
Mailing address:
  • Phone: 830-268-5040
  • Fax: 800-769-6492

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number838442
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP133935
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: