| Organization Name: | BIG BEND SLEEP CENTER, LLC |
| NPI Number: | 1558694224 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MANOHER L GURRU (MAJORITY STOCK HOLDER) |
| Mailing Address: | 387 Ih 10 W Fort Stockton |
| State: | TX US |
| Postal Code: | 797352700 |
| Phone Number: | 4323367000 |
| Fax Number: | 4323686434 |
| NPI Enumeration Date: | 09/14/2009 |
| NPI Last Update Date: | 09/14/2009 |
| 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: | |