Provider Demographics
NPI:1275718967
Name:EVANS, ANGEL RENEE
Entity Type:Individual
Prefix:MS
First Name:ANGEL
Middle Name:RENEE
Last Name:EVANS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3233 OAK ALY
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-7420
Mailing Address - Country:US
Mailing Address - Phone:512-736-6873
Mailing Address - Fax:
Practice Address - Street 1:3233 OAK ALY
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-7420
Practice Address - Country:US
Practice Address - Phone:512-736-6873
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-01
Last Update Date:2008-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist