Provider Demographics
NPI:1538871827
Name:EVANS, LORI E (RDMS,RVT)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:E
Last Name:EVANS
Suffix:
Gender:F
Credentials:RDMS,RVT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1151 CLAIREMONT LN
Mailing Address - Street 2:
Mailing Address - City:BURLESON
Mailing Address - State:TX
Mailing Address - Zip Code:76028-0312
Mailing Address - Country:US
Mailing Address - Phone:972-979-8508
Mailing Address - Fax:
Practice Address - Street 1:1151 CLAIREMONT LN
Practice Address - Street 2:
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028-0312
Practice Address - Country:US
Practice Address - Phone:972-979-8508
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-19
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1727602085U0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound