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Deactivated NPI 1104690130 Deactivated / Inactive NPI

Evoke Elysium Llc

Durable Medical Equipment & Medical Supplies • Leander, TX

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Evoke Elysium Llc has officially deactivated this NPI record and ceased active healthcare operations.

Registration / Start Date November 09, 2023

NPI Deactivation Date May 08, 2024

Total Practice Duration ~1 Years of Practice (2023 – 2024)

About Evoke Elysium Llc NPI 1104690130 Summary

Evoke Elysium Llc was a registered healthcare organization specializing in Durable Medical Equipment & Medical Supplies located in Leander, TX. Operating from its primary practice location at 2121 WILD HORSE ST, the facility provided medical services under NPI record 1104690130 prior to official deactivation on May 08, 2024.

Administrative records indicate Tariq Karedia as the registered authorized official.

Facility Location & Contact Primary Location

Facility Address

2121 Wild Horse St

Leander, TX 786415498

Telephone 2105298496

Authorized Official Information

Authorized Contact Name

Tariq Karedia

Official Telephone

2105298496

Facility Classifications & Specialties

Durable Medical Equipment & Medical Supplies Primary Taxonomy

NUCC Taxonomy Code: 332B00000X

A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.

Facility & Registry History Timeline

Chronological log of verified NPI organization updates, branch relocations, and registry updates

7 Historical Events

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NPI Profile Deactivated May 08, 2024

Record deactivated on May 08, 2024

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NPI Profile Active November 10, 2023

NPI status registered as active in NPPES database

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Updated Practice Location November 10, 2023

Registered at 2121 WILD HORSE ST, LEANDER, TX 786415498 (Tel: 2105298496)

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Updated Business Mailing Address November 10, 2023

Registered at 2121 WILD HORSE ST, LEANDER, TX 786415498

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Organization / Clinic Name Updated November 10, 2023

Operating as EVOKE ELYSIUM LLC

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Medical Taxonomy / Specialty Registered (Primary Specialty) November 10, 2023

Durable Medical Equipment & Medical Supplies

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Initial NPI Registration & Enumeration November 09, 2023

First registered as active Healthcare Organization in NPPES Database.

Patient & Community Reviews

Verified patient ratings, healthcare experiences, and facility photos

0 Reviews

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NPI Organization Metadata

NPI Number: 1104690130

Entity Type:

Organization Organization (Hospital, Clinic, Group Practice) (Type 2 NPI)

Enumeration Date: November 09, 2023

Last Update: November 10, 2023

Deactivation Date: May 08, 2024

Update or Correct Listing

Mailing Address

2121 Wild Horse St

Leander, TX 786415498

Public Domain Record This organization profile is sourced from public domain datasets published by CMS and NPPES under FOIA.

⚠️ Medical Disclaimer

Facility details are provided for public information only. In case of a medical emergency, call 911 immediately.