Provider Demographics
NPI:1376861211
Name:MAPES, EVAN L (OD)
Entity Type:Individual
Prefix:DR
First Name:EVAN
Middle Name:L
Last Name:MAPES
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:4317 MONTROSE BLVD
Mailing Address - Street 2:#2
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77006-5862
Mailing Address - Country:US
Mailing Address - Phone:713-529-3937
Mailing Address - Fax:713-529-0181
Practice Address - Street 1:4317 MONTROSE BLVD
Practice Address - Street 2:#2
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77006-5862
Practice Address - Country:US
Practice Address - Phone:713-529-3937
Practice Address - Fax:713-529-0181
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-15
Last Update Date:2010-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4834T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist