Healthcare Provider Details

I. General information

NPI: 1780809053
Provider Name (Legal Business Name): OBSTRUCTIVE SLEEP APNEA DIAGNOSTIC INCDBA OSA DIAGNOSTICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2504 RIDGE RD STE 108
ROCKWALL TX
75087-2570
US

IV. Provider business mailing address

PO BOX 1513
ROCKWALL TX
75087-1513
US

V. Phone/Fax

Practice location:
  • Phone: 972-722-4045
  • Fax: 972-722-4087
Mailing address:
  • Phone: 972-722-4045
  • Fax: 972-722-4087

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: MRS. LORI AARON
Title or Position: CEO
Credential:
Phone: 972-722-4045