Provider Demographics
NPI:1720218399
Name:SOUTH TEXAS SLEEP DISORDER CLINIC
Entity Type:Organization
Organization Name:SOUTH TEXAS SLEEP DISORDER CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:HARLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:METCALFE
Authorized Official - Suffix:
Authorized Official - Credentials:RRT
Authorized Official - Phone:913-706-7600
Mailing Address - Street 1:1201 E RIDGE RD
Mailing Address - Street 2:STE. E.
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503-1531
Mailing Address - Country:US
Mailing Address - Phone:956-682-8685
Mailing Address - Fax:956-682-5005
Practice Address - Street 1:1624 S CAROLINA ST
Practice Address - Street 2:STE. B
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-8304
Practice Address - Country:US
Practice Address - Phone:956-421-5665
Practice Address - Fax:956-421-5652
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-17
Last Update Date:2010-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXFTS235Medicare PIN