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General NPI Number Information
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NPI Number | 1518874452
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Entity Type | Organization
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Legal Business Name | PERIDOT ENTERPRISES LLC
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Dates
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Enumeration Date | 08/26/2026
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Last Update Date | 08/26/2026
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Provider Practice Location Address
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Address Line | 1910 PACIFIC AVENUE SUITE 2000-1187
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City | DALLAS
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State | TX
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Zip | 75201-4522
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Country | US
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Telephone | 469-718-9579
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Fax | 945-293-2884
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Provider Business Mailing Address
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Address Line | 1910 PACIFIC AVENUE SUITE 2000-1187
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City | DALLAS
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State | TX
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Zip | 75201-4522
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Country | US
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Telephone | 469-718-9579
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Fax | 945-293-2884
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Authorized Official
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Title or Position | OWNER
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Name | SHABRINA BAILEY
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Credential |
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Telephone | 469-718-9579
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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