Provider Demographics
NPI:1033375381
Name:EVANS, ROBERT DALE (DVM)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:DALE
Last Name:EVANS
Suffix:
Gender:M
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:675 N GILBERT RD
Mailing Address - Street 2:SUITE 148
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85234-4698
Mailing Address - Country:US
Mailing Address - Phone:480-892-1554
Mailing Address - Fax:480-892-0252
Practice Address - Street 1:675 N GILBERT RD
Practice Address - Street 2:SUITE 148
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85234-4698
Practice Address - Country:US
Practice Address - Phone:480-892-1554
Practice Address - Fax:480-892-0252
Is Sole Proprietor?:No
Enumeration Date:2008-08-05
Last Update Date:2008-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1335174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian