Gulf Coast Sleep Center And Diagnostics LLC
Clinic/Center, Sleep Disorder Diagnostic in Lake Jackson, TX. Organization (NPI-2).
NPI number1508409707
StatusActive
Last updated in NPPESOct 21, 2019
Details
- NPI
- 1508409707
- Entity type
- Organization (NPI-2)
- Legal business name
- Gulf Coast Sleep Center And Diagnostics LLC
- Organization subpart
- No
- Enumeration date
- Oct 21, 2019
- Last updated
- Oct 21, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QS1200X | Clinic/Center, Sleep Disorder Diagnostic | – | – | Yes |
Practice location
107 W Way St Ste 19Lake Jackson, TX 77566-5238
Phone 979-266-9497 · Fax 979-266-9507
Mailing address
107 W Way St Ste 19Lake Jackson, TX 77566-5238
Phone 979-266-9497 · Fax 979-266-9507
Authorized official
Holly Wagner
Office/Billing Manager
9792669497
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