| Evolve Outreach Of Texas Llc | |
|
2101 Crawford St Ste 311 Houston TX 77002-8941 | |
| (844) 553-8658 | |
| Not Available |
| Full Name | Evolve Outreach Of Texas Llc |
|---|---|
| Speciality | Case Management |
| Location | 2101 Crawford St Ste 311, Houston, Texas |
| Authorized Official Name and Position | Victor Moody (MANAGER) |
| Authorized Official Contact | 8329304898 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Evolve Outreach Of Texas Llc 2101 Crawford St Ste 311 Houston TX 77002-8941 Ph: (832) 930-4898 | Evolve Outreach Of Texas Llc 2101 Crawford St Ste 311 Houston TX 77002-8941 Ph: (844) 553-8658 |
| NPI Number | 1316393192 |
|---|---|
| Provider Enumeration Date | 05/11/2016 |
| Last Update Date | 06/23/2019 |
| Medicare PECOS PAC ID | 8628362787 |
|---|---|
| Medicare Enrollment ID | O20160811002429 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316393192 | NPI | - | NPPES |
| Provider Name | Stacey Rawls |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043249774 PECOS PAC ID: 6901903327 Enrollment ID: I20160111000649 |
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