Healthcare Provider Details

I. General information

NPI: 1861740045
Provider Name (Legal Business Name): TRANSPORTATION SLEEP SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2012
Last Update Date: 08/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 ROBBIE MINCE WAY
DESOTO TX
75115-2012
US

IV. Provider business mailing address

1001 ROBBIE MINCE WAY
DESOTO TX
75115-2012
US

V. Phone/Fax

Practice location:
  • Phone: 972-709-7190
  • Fax:
Mailing address:
  • Phone: 972-709-7190
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number1000966
License Number StateTX

VIII. Authorized Official

Name: DR. JACK GARDNER
Title or Position: CHEIF EXECUTIVE OFFICER
Credential: M.D
Phone: 214-537-8039