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General NPI Number Information
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NPI Number | 1447820972
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Entity Type | Organization
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Legal Business Name | SHALOM SLEEP SOLUTIONS
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Dates
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Enumeration Date | 06/28/2021
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Last Update Date | 06/29/2021
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Provider Practice Location Address
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Address Line | 4120 MILESTONE CT
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City | FORT WORTH
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State | TX
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Zip | 76244-8679
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Country | US
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Telephone | 817-984-8552
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Fax | 817-984-8935
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Provider Business Mailing Address
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Address Line | 8553 N BEACH ST STE 224
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City | FORT WORTH
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State | TX
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Zip | 76244-4919
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OPERATIONS MANAGER
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Name | SONJI M BLANCHARD
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Credential |
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Telephone | 817-701-8283
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 293D00000X
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Taxonomy Name | Physiological Laboratory
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License Number |
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License Number State |
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