Provider Demographics
NPI:1194368266
Name:SIERRA HEALTHCARE NETWORK LLC
Entity Type:Organization
Organization Name:SIERRA HEALTHCARE NETWORK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:469-335-2356
Mailing Address - Street 1:2727 LBJ FWY STE 326
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75234-7478
Mailing Address - Country:US
Mailing Address - Phone:214-935-5777
Mailing Address - Fax:214-935-5717
Practice Address - Street 1:2727 LBJ FWY STE 326
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75234-7478
Practice Address - Country:US
Practice Address - Phone:214-935-5777
Practice Address - Fax:214-935-5717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-22
Last Update Date:2019-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty