Provider Demographics
NPI:1407021017
Name:HMS SLEEP LAB LLC
Entity Type:Organization
Organization Name:HMS SLEEP LAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:HORN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-675-9360
Mailing Address - Street 1:PO BOX 512
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:TX
Mailing Address - Zip Code:75751
Mailing Address - Country:US
Mailing Address - Phone:903-675-9360
Mailing Address - Fax:903-675-1570
Practice Address - Street 1:606 SEVEN POINTS BLVD
Practice Address - Street 2:SUITE 11
Practice Address - City:SEVEN POINTS
Practice Address - State:TX
Practice Address - Zip Code:75143
Practice Address - Country:US
Practice Address - Phone:903-675-9360
Practice Address - Fax:903-675-1570
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-24
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXPL 7183OtherPL 7183 TX