Provider Demographics
NPI:1548240443
Name:WILLIAM NEAL EVANS MD LTD
Entity Type:Organization
Organization Name:WILLIAM NEAL EVANS MD LTD
Other - Org Name:CHILDRENS HEART CENTER NEVADA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO MD
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:NEAL
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-732-1290
Mailing Address - Street 1:3131 LA CANADA ST STE 230
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89169-2551
Mailing Address - Country:US
Mailing Address - Phone:702-732-1290
Mailing Address - Fax:702-260-1926
Practice Address - Street 1:3131 LA CANADA ST STE 230
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89169-2551
Practice Address - Country:US
Practice Address - Phone:702-732-1290
Practice Address - Fax:702-260-1926
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-18
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric CardiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100500157Medicaid
XGG007170OtherMEDI-CAL
VWCLCQMedicare PIN