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Organization

ALICE SLEEP LAB INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. RUBEN MEDINA CRTT (MANAGER)
(361) 664-1042
Entity
Organization

Contact information

Practice address
411 FLOURNOY RD, STE 200, ALICE, TX 78332-4084
(361) 664-1042
(361) 664-1091
Mailing address
PO BOX 7751, CORPUS CHRISTI, TX 78467-7751
(361) 664-1042
(361) 664-1091

Taxonomy

Speciality
Code
Description
License number
State
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
162589901
TX
01
PL7181
BCBS
TX
Enumeration date
01/23/2007
Last updated
01/05/2015
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