Provider Demographics
NPI:1033520077
Name:DURAN, TAMMY
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:
Last Name:DURAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3653 BRIARGROVE LN
Mailing Address - Street 2:1513
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75287-6136
Mailing Address - Country:US
Mailing Address - Phone:806-544-2749
Mailing Address - Fax:
Practice Address - Street 1:3653 BRIARGROVE LANE
Practice Address - Street 2:1513
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75287
Practice Address - Country:US
Practice Address - Phone:806-244-2749
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-13
Last Update Date:2014-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)