Provider Demographics
NPI:1376238451
Name:PERSISTENT EVOLUTION LLC
Entity Type:Organization
Organization Name:PERSISTENT EVOLUTION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TACOYA
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-983-8775
Mailing Address - Street 1:22742 CYPRESSWOOD DR # 1092
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77373-7121
Mailing Address - Country:US
Mailing Address - Phone:832-458-1474
Mailing Address - Fax:
Practice Address - Street 1:22742 CYPRESSWOOD DR # 1092
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77373-7121
Practice Address - Country:US
Practice Address - Phone:832-458-1474
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-06
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No251E00000XAgenciesHome Health
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No261QR0800XAmbulatory Health Care FacilitiesClinic/CenterRecovery Care