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General NPI Number Information
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NPI Number | 1932491081
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Entity Type | Organization
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Legal Business Name | EVALUATION NETWORK LLC
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Dates
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Enumeration Date | 05/09/2011
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Last Update Date | 05/09/2011
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Provider Practice Location Address
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Address Line | 4675 IH 30 SUITE 102
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City | MESQUITE
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State | TX
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Zip | 75150-2428
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Country | US
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Telephone | 800-497-4917
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Fax |
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Provider Business Mailing Address
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Address Line | 4675 IH 30 SUITE 102
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City | MESQUITE
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State | TX
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Zip | 75150-2428
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Country | US
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Telephone | 800-497-4917
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | PRIYANKA VARGHESE
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Credential |
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Telephone | 800-497-4917
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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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 | 133N00000X
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Taxonomy Name | Nutritionist
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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 | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number |
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License Number State |
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