Provider Demographics
NPI:1154991651
Name:TETTEH, DAVID N
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:N
Last Name:TETTEH
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 1:21590 DUKE ALEXANDER DR
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-1753
Mailing Address - Country:US
Mailing Address - Phone:832-477-6069
Mailing Address - Fax:
Practice Address - Street 1:21590 DUKE ALEXANDER DR
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-1753
Practice Address - Country:US
Practice Address - Phone:832-477-6069
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-28
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies