Provider Demographics
NPI:1104192731
Name:EVANS, SARAH (CNIM)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:
Last Name:EVANS
Suffix:
Gender:F
Credentials:CNIM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1455
Mailing Address - Street 2:
Mailing Address - City:WHITEHOUSE
Mailing Address - State:TX
Mailing Address - Zip Code:75791-1455
Mailing Address - Country:US
Mailing Address - Phone:903-534-0809
Mailing Address - Fax:903-939-9149
Practice Address - Street 1:1356 OLD CREEK DR
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75703-7642
Practice Address - Country:US
Practice Address - Phone:903-534-0809
Practice Address - Fax:903-939-9149
Is Sole Proprietor?:No
Enumeration Date:2012-03-28
Last Update Date:2022-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist