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General NPI Number Information
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NPI Number | 1417629338
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Entity Type | Organization
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Legal Business Name | EVA ENDOVASCULAR ACCESS CENTERS OF AMERICA PLLC
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Dates
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Enumeration Date | 09/29/2021
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Last Update Date | 10/12/2023
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Provider Practice Location Address
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Address Line | 3682 UTICA RIDGE ROAD
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City | BETTENDORF
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State | IA
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Zip | 52722
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Country | US
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Telephone | 563-279-1590
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Fax |
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Provider Business Mailing Address
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Address Line | 1350 BOYSON RD STE C1
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City | HIAWATHA
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State | IA
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Zip | 52233-2211
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Country | US
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Telephone | 319-654-6741
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Fax | 563-279-1591
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Authorized Official
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Title or Position | OPERATIONS ASSOCIATE
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Name | HALEY ANN SLIFKA
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Credential |
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Telephone | 319-654-6741
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number |
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License Number State |
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