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General NPI Number Information
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NPI Number | 1750501490
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Entity Type | Organization
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Legal Business Name | C-O-P-D SLEEP LAB, LLC
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Dates
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Enumeration Date | 04/26/2007
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Last Update Date | 12/18/2007
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Provider Practice Location Address
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Address Line | 303 E COLLEGE ST SUITE F
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City | TERRELL
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State | TX
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Zip | 75160-2717
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Country | US
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Telephone | 903-455-2885
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Fax |
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Provider Business Mailing Address
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Address Line | 303 E COLLEGE ST SUITE F
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City | TERRELL
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State | TX
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Zip | 75160-2717
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Country | US
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Telephone | 972-563-7533
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. LORI JO JANACEK
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Credential | R.N.
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Telephone | 972-563-7533
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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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