Provider Demographics
NPI:1083648059
Name:ELLIS COUNTY SLEEP CENTER, LLC
Entity Type:Organization
Organization Name:ELLIS COUNTY SLEEP CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:W
Authorized Official - Last Name:HERNDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-878-7378
Mailing Address - Street 1:PO BOX 2919
Mailing Address - Street 2:
Mailing Address - City:WAXAHACHIE
Mailing Address - State:TX
Mailing Address - Zip Code:75168-2919
Mailing Address - Country:US
Mailing Address - Phone:972-878-7378
Mailing Address - Fax:972-875-8289
Practice Address - Street 1:601 S CLAY ST
Practice Address - Street 2:STE 107
Practice Address - City:ENNIS
Practice Address - State:TX
Practice Address - Zip Code:75119-5771
Practice Address - Country:US
Practice Address - Phone:972-878-7378
Practice Address - Fax:972-875-8289
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2012-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory