Healthcare Provider Details

I. General information

NPI: 1952331951
Provider Name (Legal Business Name): SONNO SLEEP CENTER OF NEW MEXICO, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 10/07/2022
Certification Date: 10/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2311 N MESA ST STE E
EL PASO TX
79902-3575
US

IV. Provider business mailing address

1004 QUINTA ANTIGUA LN
EL PASO TX
79912-2039
US

V. Phone/Fax

Practice location:
  • Phone: 915-533-8499
  • Fax: 915-544-4929
Mailing address:
  • Phone: 915-533-8499
  • Fax: 915-544-4929

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMD2005-0728
License Number StateNM

VIII. Authorized Official

Name: GONZALO A DIAZ
Title or Position: PRESIDENT
Credential: M.D.
Phone: 915-533-8499