Healthcare Provider Details

I. General information

NPI: 1639455306
Provider Name (Legal Business Name): REM SLEEP DIAGNOSTICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2011
Last Update Date: 10/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11970 N CENTRAL EXPY STE 640
DALLAS TX
75243-3714
US

IV. Provider business mailing address

11970 N CENTRAL EXPY STE 640
DALLAS TX
75243-3714
US

V. Phone/Fax

Practice location:
  • Phone: 214-812-9490
  • Fax: 214-812-9490
Mailing address:
  • Phone: 214-812-9490
  • Fax: 214-812-9490

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MELISSA BROOKS
Title or Position: OWNER
Credential:
Phone: 214-812-9490