Provider Demographics
NPI:1114220662
Name:THE SLEEP CENTER AT CAMPBELL FAMILY PRACTICE
Entity Type:Organization
Organization Name:THE SLEEP CENTER AT CAMPBELL FAMILY PRACTICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANGER
Authorized Official - Prefix:MS
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:LEAGUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-484-5587
Mailing Address - Street 1:10950 RESOURCE PKWY STE A
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77089-6134
Mailing Address - Country:US
Mailing Address - Phone:281-484-5587
Mailing Address - Fax:281-464-6480
Practice Address - Street 1:10950 RESOURCE PKWY STE A
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77089-6134
Practice Address - Country:US
Practice Address - Phone:281-484-5587
Practice Address - Fax:281-464-6480
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CAMPBELL FAMILY PRACTICE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-12-06
Last Update Date:2010-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic