Organization Active NPI

Dafonte Medical Services, LLC

  • Prosthetic/Orthotic Supplier
  • Houston, TX
National Provider Identifier
1568456937
Registry record updated Jun 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
License
000125 Issued in TX
Legal business name
DAFONTE MEDICAL SERVICES, LLC
Practice address
1101 Highway 6 S
Houston, TX 77077-1021
Phone
(281) 498-3566
Fax
(281) 498-5388
NPI assigned
Aug 31, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Brandee Nicola Dafonte
Title
President
Phone
(281) 498-3566

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X 000125 TX Primary

Addresses

Primary practice location

1101 Highway 6 S
Houston, TX 77077-1021

Mailing address

1101 Highway 6 S
Houston, TX 77077-1021
Phone (281) 498-3566

Other identifiers 2

IdentifierTypeStateIssuer
017127401MedicaidTX
011105601MedicaidTX

National Provider Directory

National Provider Directory

Locations

1101 Highway 6 S
Houston, TX 77077
Phone (281) 498-3566

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1125446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306886400000",
    "number": "1568456937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 HIGHWAY 6 S",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770771021",
            "telephone_number": "281-498-3566",
            "fax_number": "281-498-5388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 HIGHWAY 6 S",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770771021",
            "telephone_number": "281-498-3566",
            "fax_number": "281-498-5388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAFONTE MEDICAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-31",
        "last_updated": "2011-06-01",
        "status": "A",
        "authorized_official_last_name": "DAFONTE",
        "authorized_official_first_name": "BRANDEE",
        "authorized_official_middle_name": "NICOLA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "281-498-3566",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "TX",
            "license": "000125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "017127401",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "011105601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.