Provider Demographics
NPI:1467600130
Name:PHYSICIANS SLEEP CENTER LLC
Entity Type:Organization
Organization Name:PHYSICIANS SLEEP CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER MBR
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:A
Authorized Official - Last Name:ACREMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-761-0333
Mailing Address - Street 1:5219 CITY BANK PKWY
Mailing Address - Street 2:SUITE 135
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79407-3544
Mailing Address - Country:US
Mailing Address - Phone:806-761-0333
Mailing Address - Fax:806-722-2908
Practice Address - Street 1:7202 SLIDE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79424-2553
Practice Address - Country:US
Practice Address - Phone:806-761-0499
Practice Address - Fax:806-722-1056
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-05
Last Update Date:2012-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX204227701Medicaid
TX204227701Medicaid