Organization Name: | MAINLAND AMERICAN SLEEP DIAGNOSTIC CENTER, INC. |
NPI Number: | 1093735839 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DEVIN M CLENNON (PRESIDENT) |
Mailing Address: | 6502 Memorial Dr Texas City |
State: | TX US |
Postal Code: | 775914016 |
Phone Number: | 2812186990 |
Fax Number: | 2812187969 |
NPI Enumeration Date: | 07/21/2006 |
NPI Last Update Date: | 10/28/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QS1200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Sleep Disorder Diagnostic |
Taxonomy Definition: |