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General NPI Number Information
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NPI Number | 1972658268
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Entity Type | Organization
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Legal Business Name | SOUTHERN SLEEP DIAGNOSTICS INC
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Dates
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Enumeration Date | 01/24/2007
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Last Update Date | 09/17/2021
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Provider Practice Location Address
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Address Line | 4764 RESEARCH DR
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City | SAN ANTONIO
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State | TX
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Zip | 78240-5002
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Country | US
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Telephone | 210-614-9775
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Fax | 210-614-2891
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Provider Business Mailing Address
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Address Line | 4764 RESEARCH DR
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City | SAN ANTONIO
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State | TX
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Zip | 78240-5002
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Country | US
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Telephone | 210-614-9775
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Fax | 210-614-2891
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. JENNY A LUNA
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Credential |
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Telephone | 210-614-9775
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 0067810
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License Number State | TX
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