Provider Demographics
NPI:1922033422
Name:NEW MEXICO SLEEP DIAGNOSTICS
Entity Type:Organization
Organization Name:NEW MEXICO SLEEP DIAGNOSTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:ERIC
Authorized Official - Last Name:COLLIER
Authorized Official - Suffix:
Authorized Official - Credentials:BS,RRT
Authorized Official - Phone:505-647-2666
Mailing Address - Street 1:PO BOX 1234
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88004-1234
Mailing Address - Country:US
Mailing Address - Phone:505-647-2666
Mailing Address - Fax:505-524-1237
Practice Address - Street 1:1605 EL PASEO RD
Practice Address - Street 2:SUITE C
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88001-6013
Practice Address - Country:US
Practice Address - Phone:505-647-2666
Practice Address - Fax:505-524-1237
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Not Answered293D00000XLaboratoriesPhysiological Laboratory