Provider Demographics
NPI:1639588536
Name:SLEEP DIAGNOSTIC CENTER
Entity Type:Organization
Organization Name:SLEEP DIAGNOSTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:FLORES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-442-7740
Mailing Address - Street 1:6225 SARATOGA BLVD APT 305
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78414-3443
Mailing Address - Country:US
Mailing Address - Phone:361-442-7740
Mailing Address - Fax:361-232-5695
Practice Address - Street 1:5826 ESPLANADE DR STE 202
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414-4198
Practice Address - Country:US
Practice Address - Phone:361-442-7740
Practice Address - Fax:361-232-5695
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-05
Last Update Date:2014-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic