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Organization
TDME
Active
Organization
TDME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARTIN FULLER (OWNER)
(469) 395-8402
Entity
Organization
Contact information
Practice address
6565 N MACARTHUR BLVD STE 225, IRVING, TX 75039-2482
(469) 395-8402
Mailing address
4049 COVENT GARDEN LN, FRISCO, TX 75034-8364
(469) 395-8402
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
NULL
Other
Enumeration date
03/26/2020
Last updated
03/26/2020
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