Provider Demographics
NPI:1770606972
Name:EVANS, ROBERT MARK (LCSW, ACSW)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:MARK
Last Name:EVANS
Suffix:
Gender:M
Credentials:LCSW, ACSW
Other - Prefix:MR
Other - First Name:MARK
Other - Middle Name:
Other - Last Name:EVANS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW, ACSW
Mailing Address - Street 1:3600 MONTROSE BLVD
Mailing Address - Street 2:UNIT 1103
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77006-4658
Mailing Address - Country:US
Mailing Address - Phone:713-447-2656
Mailing Address - Fax:
Practice Address - Street 1:1155 PRESSLER ST
Practice Address - Street 2:UT MD ANDERSON CANCER PREVENTION BLDG UNIT 1330
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-3721
Practice Address - Country:US
Practice Address - Phone:713-792-5927
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX194751041C0700X
NYR04131211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical