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General NPI Number Information
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NPI Number | 1568749091
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Entity Type | Organization
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Legal Business Name | SUN DIAGNOSTICS LP
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Dates
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Enumeration Date | 11/11/2011
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Last Update Date | 11/11/2011
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Provider Practice Location Address
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Address Line | 4400 N MIDLAND DR SUITE 506
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City | MIDLAND
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State | TX
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Zip | 79707-3385
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Country | US
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Telephone | 432-689-4400
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Fax | 432-689-4401
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Provider Business Mailing Address
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Address Line | 4400 N MIDLAND DR SUITE 506
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City | MIDLAND
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State | TX
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Zip | 79707-3385
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Country | US
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Telephone | 432-689-4400
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Fax | 432-689-4401
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | MR. PRASANNA ATHYALA
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Credential |
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Telephone | 432-689-4400
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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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