Provider Demographics
NPI:1265689657
Name:DIAMOND SLEEP LAB, INC
Entity Type:Organization
Organization Name:DIAMOND SLEEP LAB, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-868-4555
Mailing Address - Street 1:6140 HIGHWAY SIX SOUTH
Mailing Address - Street 2:PMB #85
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459
Mailing Address - Country:US
Mailing Address - Phone:281-499-3945
Mailing Address - Fax:281-499-3958
Practice Address - Street 1:4501 CARTWRIGHT RD
Practice Address - Street 2:SUITE 401
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459
Practice Address - Country:US
Practice Address - Phone:281-499-3945
Practice Address - Fax:281-499-3958
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DIAMOND SLEEP LAB, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-08-27
Last Update Date:2009-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic