Provider Demographics
NPI:1881993582
Name:INNOVA SLEEP AND DIAGNOSTIC CENTER
Entity type:Organization
Organization Name:INNOVA SLEEP AND DIAGNOSTIC CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:C.E.O. PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-398-1908
Mailing Address - Street 1:14603 LAURA CIR
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-3312
Mailing Address - Country:US
Mailing Address - Phone:281-355-0158
Mailing Address - Fax:281-355-0158
Practice Address - Street 1:14603 LAURA CIR
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-3312
Practice Address - Country:US
Practice Address - Phone:281-355-0158
Practice Address - Fax:281-355-0158
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-21
Last Update Date:2011-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173F00000XOther Service ProvidersSleep Specialist, PhDGroup - Multi-Specialty