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NPI Code Detail

MEDICARE: WILLIAM NEAL EVANS MD LTD

MEDICARE: WILLIAM NEAL EVANS MD LTD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor
2133V00000XRegistered Dietitian
3170300000XGenetic Counselor (M.S.)
4363LF0000XFamily Nurse Practitioner
52080P0202XPediatric Cardiology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2XGG007170OTHERMEDI-CAL

General Provider Information

NPI Number : 1548240443
Entity Type Code : Organization
Provider Name (Legal Business Name) : WILLIAM NEAL EVANS MD LTD
Provider Business Mailing Address
First Line : 3131 LA CANADA ST STE 230
Second Line :
City : LAS VEGAS
State : NV
Zip : 89169-2551
Country : US
Telephone Number : 702-732-1290
Fax Number : 702-260-1926
Provider Business Practice Location Address
First Line : 3131 LA CANADA ST STE 230
Second Line :
City : LAS VEGAS
State : NV
Zip : 89169-2551
Country : US
Telephone Number : 702-732-1290
Fax Number : 702-260-1926
Authorized Official
Title or Position : CREDENTIALING MANAGER
Name : LESLIE JOHNSON
Credential :
Telephone Number : 702-990-4821
Provider Enumeration Date : 01/18/2006
Last Update Date : 05/01/2025

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Directions to “WILLIAM NEAL EVANS MD LTD ” Practice Location

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