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General NPI Number Information
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NPI Number | 1790583722
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Entity Type | Organization
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Legal Business Name | DTK VENTURES LLC
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Dates
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Enumeration Date | 03/05/2025
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Last Update Date | 03/05/2025
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Provider Practice Location Address
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Address Line | 3222 ROY ALTON BND
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City | MELISSA
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State | TX
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Zip | 75454-9764
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Country | US
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Telephone | 314-240-7764
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Fax |
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Provider Business Mailing Address
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Address Line | 3222 ROY ALTON BND
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City | MELISSA
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State | TX
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Zip | 75454-9764
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Country | US
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Telephone | 314-240-7764
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Fax |
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Authorized Official
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Title or Position | GENERAL MANAGER
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Name | ABIDEMI AJAYI
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Credential | PHARM D
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Telephone | 314-240-7764
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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