MEDICARE: LAREDO SLEEP CENTER LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QS1200X	Sleep Disorder Diagnostic Clinic/Center	802305795	TX

General Provider Information

NPI Number	:	1881050201
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAREDO SLEEP CENTER LLC

Provider Business Mailing Address
First Line	:	PO BOX 2649
Second Line	:
City	:	LAREDO
State	:	TX
Zip	:	78044-2649
Country	:	US
Telephone Number	:	956-725-1228
Fax Number	:	956-727-5201

Provider Business Practice Location Address
First Line	:	6999 MCPHERSON RD STE 327
Second Line	:
City	:	LAREDO
State	:	TX
Zip	:	78041-6451
Country	:	US
Telephone Number	:	956-725-1228
Fax Number	:	956-727-5201

Authorized Official
Title or Position	:	OWNER
Name	:	RICARDO G CIGARROA
Credential	:	MD
Telephone Number	:	956-725-1228

Provider Enumeration Date	:	01/14/2016
Last Update Date	:	01/14/2016

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