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NPI Code Detail

MEDICARE: TDME

MEDICARE: TDME
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332B00000XDurable Medical Equipment & Medical Supplies

General Provider Information

NPI Number : 1336776509
Entity Type Code : Organization
Provider Name (Legal Business Name) : TDME
Provider Business Mailing Address
First Line : 4049 COVENT GARDEN LN
Second Line :
City : FRISCO
State : TX
Zip : 75034-8364
Country : US
Telephone Number : 469-395-8402
Fax Number :
Provider Business Practice Location Address
First Line : 6565 N MACARTHUR BLVD STE 225
Second Line :
City : IRVING
State : TX
Zip : 75039-2482
Country : US
Telephone Number : 469-395-8402
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MARTIN FULLER
Credential :
Telephone Number : 469-395-8402
Provider Enumeration Date : 03/26/2020
Last Update Date : 03/26/2020

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Directions to “TDME ” Practice Location

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