Provider Demographics
NPI:1710046651
Name:GULF ADVANCED DIAGNOSTICS SLEEP CENTER INC.
Entity Type:Organization
Organization Name:GULF ADVANCED DIAGNOSTICS SLEEP CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:CRUMBLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-795-0302
Mailing Address - Street 1:8111 NORTH STADIUM DRIVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-1826
Mailing Address - Country:US
Mailing Address - Phone:713-795-0302
Mailing Address - Fax:713-795-0300
Practice Address - Street 1:8111 NORTH STADIUM DRIVE
Practice Address - Street 2:SUITE 200
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-1826
Practice Address - Country:US
Practice Address - Phone:713-795-0302
Practice Address - Fax:713-795-0300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXPL7174OtherBC BS PROVIDER NUMBER