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Organization
EVOSOURCE
Active
Organization
EVOSOURCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EMMITT WALTON (OWNER)
(281) 389-1461
Entity
Organization
Contact information
Practice address
1307 PEACHAM CT, FRESNO, TX 77545
(281) 389-1461
(281) 849-4636
Mailing address
1307 PEACHAM CT, FRESNO, TX 77545-9554
(281) 389-1461
(281) 849-4636
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
—
NULL
347C00000X
Private Vehicle
Primary
—
NULL
Other
Enumeration date
05/29/2015
Last updated
05/29/2015
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