Healthcare Provider Details

I. General information

NPI: 1073494969
Provider Name (Legal Business Name): EVENCARE LOGISTICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4807 SUGAR GROVE BLVD STE 501
STAFFORD TX
77477-2652
US

IV. Provider business mailing address

4807 SUGAR GROVE BLVD STE 501
STAFFORD TX
77477-2652
US

V. Phone/Fax

Practice location:
  • Phone: 979-618-0124
  • Fax:
Mailing address:
  • Phone: 979-618-0124
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code343800000X
TaxonomySecured Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: ELVIS NSOM
Title or Position: SOLE MANAGER
Credential:
Phone: 281-965-8051