Provider Demographics
NPI:1073702528
Name:SOUTHWEST SLEEP LAB
Entity Type:Organization
Organization Name:SOUTHWEST SLEEP LAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR
Authorized Official - Prefix:DR
Authorized Official - First Name:PANKAJ
Authorized Official - Middle Name:K
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD, FCCP, DASM
Authorized Official - Phone:281-342-3342
Mailing Address - Street 1:8200 WEDNESBURY LN STE 300
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-2932
Mailing Address - Country:US
Mailing Address - Phone:281-342-3342
Mailing Address - Fax:281-342-0833
Practice Address - Street 1:8200 WEDNESBURY LN STE 300
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-2932
Practice Address - Country:US
Practice Address - Phone:281-342-3342
Practice Address - Fax:281-342-0833
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-22
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic