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General NPI Number Information
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NPI Number | 1770606972
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Entity Type | Individual
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Provider Name | ROBERT MARK EVANS LCSW, ACSW
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Gender | Male
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Dates
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Enumeration Date | 04/10/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1155 PRESSLER ST UT MD ANDERSON CANCER PREVENTION BLDG UNIT 1330
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City | HOUSTON
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State | TX
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Zip | 77030-3721
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Country | US
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Telephone | 713-792-5927
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Fax |
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Provider Business Mailing Address
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Address Line | 3600 MONTROSE BLVD UNIT 1103
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City | HOUSTON
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State | TX
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Zip | 77006-4658
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Country | US
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Telephone | 713-447-2656
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 19475
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | R0413121
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License Number State | NY
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