Individual
DR. SHANE M EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1905 E P TRUE PARKWAY, STE 103, WEST DES MOINES, IA 50265
(515) 225-0877
(515) 225-9518
Mailing address
1905 E P TRUE PARKWAY, STE 103, WEST DES MOINES, IA 50265
(515) 225-0877
(515) 225-9518
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
01940
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0065482
—
IA
05
—
2065482
—
IA
05
—
3065482
—
IA
Enumeration date
05/08/2006
Last updated
02/19/2008
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