Provider Demographics
NPI:1982914495
Name:MEDEVAC EMS
Entity Type:Organization
Organization Name:MEDEVAC EMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-623-8859
Mailing Address - Street 1:201 LAURENCE DR
Mailing Address - Street 2:PO BOX 202
Mailing Address - City:HEATH
Mailing Address - State:TX
Mailing Address - Zip Code:75032-2069
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4300 FORNEY RD
Practice Address - Street 2:SUITE 108
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75149-2747
Practice Address - Country:US
Practice Address - Phone:972-623-8869
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-18
Last Update Date:2010-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
No3416L0300XTransportation ServicesAmbulanceLand Transport