Provider Demographics
NPI:1932491081
Name:EVALUATION NETWORK LLC
Entity Type:Organization
Organization Name:EVALUATION NETWORK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:PRIYANKA
Authorized Official - Middle Name:
Authorized Official - Last Name:VARGHESE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-497-4917
Mailing Address - Street 1:4675 IH 30
Mailing Address - Street 2:SUITE 102
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150-2428
Mailing Address - Country:US
Mailing Address - Phone:800-497-4917
Mailing Address - Fax:
Practice Address - Street 1:4675 IH 30
Practice Address - Street 2:SUITE 102
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-2428
Practice Address - Country:US
Practice Address - Phone:800-497-4917
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-09
Last Update Date:2011-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Multi-Specialty