Healthcare Provider Details

I. General information

NPI: 1265039671
Provider Name (Legal Business Name): JANE'S HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2020
Last Update Date: 10/08/2020
Certification Date: 10/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 PARK WEST DR
SUGAR LAND TX
77478-2861
US

IV. Provider business mailing address

625 PARK WEST DR
SUGAR LAND TX
77478-2861
US

V. Phone/Fax

Practice location:
  • Phone: 281-637-2221
  • Fax: 832-900-8675
Mailing address:
  • Phone: 281-637-2221
  • Fax: 832-900-8675

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JANE BUNCH
Title or Position: CEO
Credential:
Phone: 281-637-2221