Provider Demographics
NPI:1770976334
Name:LIVINGSTON SLEEP LAB
Entity type:Organization
Organization Name:LIVINGSTON SLEEP LAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ABRAHAM
Authorized Official - Middle Name:
Authorized Official - Last Name:CHERIYAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:936-639-1110
Mailing Address - Street 1:206 GASLIGHT BLVD
Mailing Address - Street 2:
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75904-3166
Mailing Address - Country:US
Mailing Address - Phone:936-639-1110
Mailing Address - Fax:936-639-2466
Practice Address - Street 1:210 W PARK STE 108
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:TX
Practice Address - Zip Code:77351-8338
Practice Address - Country:US
Practice Address - Phone:936-328-7959
Practice Address - Fax:936-327-5964
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-06
Last Update Date:2015-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic