Direct Destination Delivery Service

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

License

21038722 Issued in TX

Legal business name

DIRECT DESTINATION DELIVERY SERVICE

Practice address

4936 Brazoswood Cir
Arlington, TX 76017-1094

Phone

(682) 551-7179

NPI assigned

Sep 8, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Derald Demond Datcher

Title

Owner/Operator

Phone

(682) 551-7179

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1252368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252368000000",
    "number": "1679806764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4936 BRAZOSWOOD CIR",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760171094",
            "telephone_number": "682-551-7179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4936 BRAZOSWOOD CIR",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760171094",
            "telephone_number": "682-551-7179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIRECT DESTINATION DELIVERY SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-08",
        "last_updated": "2009-09-08",
        "status": "A",
        "authorized_official_last_name": "DATCHER",
        "authorized_official_first_name": "DERALD",
        "authorized_official_middle_name": "DEMOND",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "682-551-7179",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "TX",
            "license": "21038722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Non-emergency Medical Transport (VAN) in Arlington, TX
• Providers in Arlington, TX by specialty
• Non-emergency Medical Transport (VAN) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2009; 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.