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General NPI Number Information
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NPI Number | 1700951118
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Entity Type | Organization
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Legal Business Name | FAMILY SLEEP DIAGNOSTICS
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Dates
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Enumeration Date | 11/21/2006
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Last Update Date | 08/07/2019
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Provider Practice Location Address
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Address Line | 1717 PRECINCT LINE RD STE 105
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City | HURST
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State | TX
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Zip | 76054-3169
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Country | US
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Telephone | 972-714-0011
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Fax | 855-501-0111
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Provider Business Mailing Address
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Address Line | 318 BLANCO CIR
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City | SOUTHLAKE
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State | TX
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Zip | 76092-6036
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Country | US
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Telephone | 817-726-1550
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Fax | 855-501-0111
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | ERIC STENGLE
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Credential |
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Telephone | 817-726-1550
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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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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 173F00000X
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Taxonomy Name | Sleep Specialist (PhD)
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License Number | J1041
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License Number State | TX
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