Provider Demographics
NPI:1184433948
Name:HOUGH, EVAN
Entity type:Individual
Prefix:
First Name:EVAN
Middle Name:
Last Name:HOUGH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17800 GEORGE MILLER PKWY
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68116-3300
Mailing Address - Country:US
Mailing Address - Phone:402-289-0322
Mailing Address - Fax:
Practice Address - Street 1:17800 GEORGE MILLER PKWY
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68116-3300
Practice Address - Country:US
Practice Address - Phone:402-289-0322
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-06
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant