Healthcare Provider Details

I. General information

NPI: 1083204143
Provider Name (Legal Business Name): TDDP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2021
Last Update Date: 06/28/2024
Certification Date: 06/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14400 W SYLVANFIELD DR
HOUSTON TX
77014-1625
US

IV. Provider business mailing address

9710 WILDWOOD ROSE CT
SPRING TX
77379-1620
US

V. Phone/Fax

Practice location:
  • Phone: 832-798-1655
  • Fax: 281-213-0656
Mailing address:
  • Phone: 832-798-1655
  • Fax: 281-213-0656

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code171WH0202X
TaxonomyHome Modifications Contractor
License Number
License Number State

VIII. Authorized Official

Name: MR. DARRYL PREVOST
Title or Position: OWNER
Credential:
Phone: 832-798-1655