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General NPI Number Information
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NPI Number | 1366536336
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Entity Type | Organization
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Legal Business Name | EL PASO SLEEP CENTER, INC.
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1016 QUINTA ANTIGUA LN
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City | EL PASO
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State | TX
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Zip | 79912-2039
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Country | US
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Telephone | 915-779-7378
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Fax |
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Provider Business Mailing Address
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Address Line | 1770 AIRWAY BLVD SUITE 307
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City | EL PASO
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State | TX
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Zip | 79925-1035
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Country | US
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Telephone | 915-779-7378
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Fax | 915-779-2822
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GONZALO ARTURO DIAZ
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Credential | MD, FCCP, ACP
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Telephone | 915-779-7378
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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 | G4109
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License Number State | TX
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