Provider Demographics
NPI:1326766064
Name:DURAN, DANTE JACE
Entity Type:Individual
Prefix:
First Name:DANTE
Middle Name:JACE
Last Name:DURAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3002 CENTENNIAL VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-6088
Mailing Address - Country:US
Mailing Address - Phone:832-837-0605
Mailing Address - Fax:
Practice Address - Street 1:2805 BUSINESS CENTER DR
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-2191
Practice Address - Country:US
Practice Address - Phone:832-837-0605
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-18
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician