Provider Demographics
NPI:1093764961
Name:NORTH TEXAS SLEEP LAB, L.L.P.
Entity Type:Organization
Organization Name:NORTH TEXAS SLEEP LAB, L.L.P.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER, OPERATIONS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:W
Authorized Official - Last Name:THEDFORD
Authorized Official - Suffix:
Authorized Official - Credentials:BS, RPSGT
Authorized Official - Phone:214-739-6300
Mailing Address - Street 1:5489 BLAIR RD
Mailing Address - Street 2:STE 100
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-4179
Mailing Address - Country:US
Mailing Address - Phone:214-739-6300
Mailing Address - Fax:214-739-6305
Practice Address - Street 1:5489 BLAIR RD
Practice Address - Street 2:STE 100
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4179
Practice Address - Country:US
Practice Address - Phone:214-739-6300
Practice Address - Fax:214-739-6305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXFTS056Medicare ID - Type Unspecified