Provider Demographics
NPI:1558765610
Name:PULMONARY AND SLEEP DISORDERS PLLC
Entity Type:Organization
Organization Name:PULMONARY AND SLEEP DISORDERS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANTOINE
Authorized Official - Middle Name:G
Authorized Official - Last Name:HABRE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:276-228-8800
Mailing Address - Street 1:590 W RIDGE RD
Mailing Address - Street 2:SUITE I
Mailing Address - City:WYTHEVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24382-1094
Mailing Address - Country:US
Mailing Address - Phone:276-228-8800
Mailing Address - Fax:276-228-8808
Practice Address - Street 1:590 W RIDGE RD
Practice Address - Street 2:SUITE I
Practice Address - City:WYTHEVILLE
Practice Address - State:VA
Practice Address - Zip Code:24382-1094
Practice Address - Country:US
Practice Address - Phone:276-228-8800
Practice Address - Fax:276-228-8808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-18
Last Update Date:2014-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101240438207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty