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NPI 1144481680

NPI 1144481680 : TEXAS CENTER FOR SLEEP DISORDERS AT WILLOW BEND LP : PLANO, TX

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General NPI Number Information
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    NPI Number           |    1144481680
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    Entity Type          |    Organization 
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    Legal Business Name  |    TEXAS CENTER FOR SLEEP DISORDERS AT WILLOW BEND LP 
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Dates
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    Enumeration Date     |    06/18/2008
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    Last Update Date     |    01/27/2011
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Provider Practice Location Address
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    Address Line         |    5944 W PARKER RD STE 300 
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    City                 |    PLANO
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    State                |    TX
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    Zip                  |    75093-6421
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    Country              |    US
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    Telephone            |    469-241-0081
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    210 PARK AVE SUITE 1350
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    City                 |    OKLAHOMA CITY
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    State                |    OK
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    Zip                  |    73102-5636
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    Country              |    US
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    Telephone            |    405-285-4914
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    Fax                  |    405-285-7127
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Authorized Official
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    Title or Position    |    PRESIDENT & CEO
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    Name                 |     LEWIS P ZEIDNER 
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    Credential           |    
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    Telephone            |    763-432-8401
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    261QS1200X
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    Taxonomy Name        |    Sleep Disorder Diagnostic Clinic/Center
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    License Number       |    
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    License Number State |    
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