Healthcare Provider Details

I. General information

NPI: 1134240765
Provider Name (Legal Business Name): DFW SLEEP DIAGNOSTIC CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2653 SAGEBRUSH DR STE 210
FLOWER MOUND TX
75028-2748
US

IV. Provider business mailing address

4 SAINT ANN DR
MANDEVILLE LA
70471-3265
US

V. Phone/Fax

Practice location:
  • Phone: 972-899-6059
  • Fax: 972-899-6351
Mailing address:
  • Phone: 985-626-6211
  • Fax: 985-626-6227

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number0072884
License Number StateTX

VIII. Authorized Official

Name: BETSY RIVAS
Title or Position: AR DIRECTOR
Credential:
Phone: 985-626-6211