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General NPI Number Information
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NPI Number | 1891947792
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Entity Type | Organization
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Legal Business Name | ELSA SLEEP CENTER, LLC
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Dates
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Enumeration Date | 10/22/2008
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Last Update Date | 05/01/2009
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Provider Practice Location Address
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Address Line | 701 E EDINBURG AVE SUITE F
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City | ELSA
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State | TX
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Zip | 78543-9999
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Country | US
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Telephone | 956-262-8868
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Fax | 956-661-8005
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Provider Business Mailing Address
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Address Line | PO BOX 2130
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City | ELSA
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State | TX
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Zip | 78543-2130
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Country | US
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Telephone | 956-262-8868
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Fax | 956-661-8005
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Authorized Official
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Title or Position | OWNER
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Name | MR. ORLANDO SANDOVAL
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Credential | CRT/RCP
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Telephone | 956-272-9844
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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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