Provider Demographics
NPI:1346797560
Name:ENT EVOKES, LLC
Entity Type:Organization
Organization Name:ENT EVOKES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CARMEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-919-3549
Mailing Address - Street 1:5729 LEBANON RD
Mailing Address - Street 2:SUITE 144
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-7260
Mailing Address - Country:US
Mailing Address - Phone:469-919-3549
Mailing Address - Fax:
Practice Address - Street 1:5729 LEBANON RD
Practice Address - Street 2:SUITE 144
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-7260
Practice Address - Country:US
Practice Address - Phone:469-919-3549
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-06
Last Update Date:2016-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnosticGroup - Multi-Specialty