Provider Demographics
NPI:1134464480
Name:SIRIUS HEALTH SOLUTIONS LLC
Entity Type:Organization
Organization Name:SIRIUS HEALTH SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKENNA
Authorized Official - Suffix:
Authorized Official - Credentials:RN BSN FNP-BC
Authorized Official - Phone:432-685-0633
Mailing Address - Street 1:400 N GARFIELD
Mailing Address - Street 2:SUITE 271
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79701-5904
Mailing Address - Country:US
Mailing Address - Phone:432-685-0633
Mailing Address - Fax:
Practice Address - Street 1:400 N GARFIELD
Practice Address - Street 2:SUITE 271
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79701-5904
Practice Address - Country:US
Practice Address - Phone:432-685-0633
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-27
Last Update Date:2012-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX235771261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty