Healthcare Provider Details

I. General information

NPI: 1548178635
Provider Name (Legal Business Name): DURAVANTA MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

810A STEELE RD
HIGHLANDS TX
77562-4345
US

IV. Provider business mailing address

15270 VOSS RD APT 311
SUGAR LAND TX
77498-4771
US

V. Phone/Fax

Practice location:
  • Phone: 352-659-4545
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateNULL

VIII. Authorized Official

Name: LINDA YORK
Title or Position: OWNER
Credential:
Phone: 352-659-4545