Provider Demographics
NPI:1871920330
Name:DIAGNOSTIC SLEEP OF THE MEDICAL CENTER LLC
Entity type:Organization
Organization Name:DIAGNOSTIC SLEEP OF THE MEDICAL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:HENRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-319-4910
Mailing Address - Street 1:PO BOX 62002
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77205-2002
Mailing Address - Country:US
Mailing Address - Phone:281-319-4910
Mailing Address - Fax:832-644-9503
Practice Address - Street 1:6400 FANNIN ST
Practice Address - Street 2:STE 2280
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-1521
Practice Address - Country:US
Practice Address - Phone:281-319-4910
Practice Address - Fax:832-644-9503
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-30
Last Update Date:2013-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherGroup - Single Specialty