Provider Demographics
NPI:1811762628
Name:TATCHI-BANDA, DALLYDA (MSW)
Entity type:Individual
Prefix:
First Name:DALLYDA
Middle Name:
Last Name:TATCHI-BANDA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2750 FM 1463 RD STE 150
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-6893
Mailing Address - Country:US
Mailing Address - Phone:832-557-9243
Mailing Address - Fax:
Practice Address - Street 1:18650 CLAY RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-7240
Practice Address - Country:US
Practice Address - Phone:832-557-9243
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-21
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula