Organization Name: | ALICE SLEEP LAB INC |
NPI Number: | 1265586689 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RUBEN MEDINA (MANAGER) |
Mailing Address: | 411 Flournoy Rd Ste 200 Alice |
State: | TX US |
Postal Code: | 783324084 |
Phone Number: | 3616641042 |
Fax Number: | 3616641091 |
NPI Enumeration Date: | 01/23/2007 |
NPI Last Update Date: | 01/05/2015 |
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: |