Healthcare Provider Details

I. General information

NPI: 1548536444
Provider Name (Legal Business Name): TX SLEEP CENTERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2012
Last Update Date: 07/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

331 MELROSE DR STE 145
RICHARDSON TX
75080
US

IV. Provider business mailing address

331 MELROSE DR STE 145
RICHARDSON TX
75080-4405
US

V. Phone/Fax

Practice location:
  • Phone: 877-333-2575
  • Fax: 800-840-8626
Mailing address:
  • Phone: 877-333-2575
  • Fax: 800-840-8626

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code246ZE0500X
TaxonomyEEG Specialist/Technologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2472E0500X
TaxonomyEEG Technician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code293D00000X
TaxonomyPhysiological Laboratory
License Number
License Number State

VIII. Authorized Official

Name: DEREK LANCASTER
Title or Position: OWNER
Credential:
Phone: 985-789-6636