MEDICARE: NEVADA PULMONARY DIAGNOSTICS AND SLEEP DISORDERS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QS1200X	Sleep Disorder Diagnostic Clinic/Center		NV

General Provider Information

NPI Number	:	1003057647
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEVADA PULMONARY DIAGNOSTICS AND SLEEP DISORDERS

Provider Business Mailing Address
First Line	:	7500 W. LAKE MEAD BLVD.
Second Line	:	SUITE 314
City	:	LAS VEGAS
State	:	NV
Zip	:	89128
Country	:	US
Telephone Number	:	702-722-4346
Fax Number	:

Provider Business Practice Location Address
First Line	:	7500 W LAKE MEAD BLVD
Second Line	:	SUITE 314
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-0297
Country	:	US
Telephone Number	:	702-722-4346
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	DR. DENNIS ALLEN FALLS
Credential	:	M.D./PHD
Telephone Number	:	702-722-4346

Provider Enumeration Date	:	03/11/2009
Last Update Date	:	03/11/2009

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