MEDICARE: NEVADA ANESTHESIA TEAM PLLC

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
1	207L00000X	Anesthesiology Physician

General Provider Information

NPI Number	:	1851121677
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEVADA ANESTHESIA TEAM PLLC

Provider Business Mailing Address
First Line	:	9709 LAKESIDE BLVD STE 350
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77381-1213
Country	:	US
Telephone Number	:	713-489-2198
Fax Number	:	713-489-2978

Provider Business Practice Location Address
First Line	:	4275 BURNHAM AVE STE 101
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-5400
Country	:	US
Telephone Number	:	702-470-2948
Fax Number	:	725-257-7684

Authorized Official
Title or Position	:	OWNER
Name	:	EDD LAWSON EVANS
Credential	:	MD
Telephone Number	:	702-306-6535

Provider Enumeration Date	:	08/06/2024
Last Update Date	:	08/06/2024

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