Provider Demographics
NPI:1881034775
Name:DFW SLEEP DIAGNOSTICS LLC
Entity Type:Organization
Organization Name:DFW SLEEP DIAGNOSTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:DEREJE
Authorized Official - Middle Name:
Authorized Official - Last Name:AYO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:817-568-8411
Mailing Address - Street 1:11803 SOUTH FWY STE 311
Mailing Address - Street 2:
Mailing Address - City:BURLESON
Mailing Address - State:TX
Mailing Address - Zip Code:76028-7036
Mailing Address - Country:US
Mailing Address - Phone:817-568-8411
Mailing Address - Fax:
Practice Address - Street 1:11803 SOUTH FWY STE 311
Practice Address - Street 2:
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028-7036
Practice Address - Country:US
Practice Address - Phone:817-568-8411
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-25
Last Update Date:2013-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN0617261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic