Provider Demographics
NPI:1902977309
Name:SLEEP CENTER AT DOCTORS HOSPITAL LLC
Entity Type:Organization
Organization Name:SLEEP CENTER AT DOCTORS HOSPITAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER-MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:N
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-692-8125
Mailing Address - Street 1:509 W TIDWELL RD
Mailing Address - Street 2:STE. 301
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77091-4352
Mailing Address - Country:US
Mailing Address - Phone:713-692-8125
Mailing Address - Fax:713-692-8227
Practice Address - Street 1:509 W TIDWELL RD
Practice Address - Street 2:STE. 301
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77091-4352
Practice Address - Country:US
Practice Address - Phone:713-692-8125
Practice Address - Fax:713-692-8227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-10
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX165275202Medicaid
TX165275202Medicaid