Healthcare Provider Details
I. General information
NPI: 1174783625
Provider Name (Legal Business Name): METRO SLEEP CENTER EAST
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/09/2008
Last Update Date: 06/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
12640 E NORTHWEST HWY SUITE 406
DALLAS TX
75228-8015
US
IV. Provider business mailing address
2504 RIDGE RD SUITE 108
ROCKWALL TX
75087-2569
US
V. Phone/Fax
- Phone: 972-722-4045
- Fax: 972-722-4087
- Phone: 972-722-4045
- Fax: 972-722-4087
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QS1200X |
| Taxonomy | Sleep Disorder Diagnostic Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
LORI
S.
AARON
Title or Position: CEO
Credential:
Phone: 972-722-4045