Organization
PRIME SLEEP SERVICES GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACK GARDNER MD (OWNER)
(214) 537-8039
Entity
Organization
Contact information
Practice address
6401 ELDORADO PKWY, 304, MCKINNEY, TX 75070-5887
(214) 620-2057
(214) 620-2058
Mailing address
6401 ELDORADO PKWY, 304, MCKINNEY, TX 75070-5887
(214) 620-2057
(214) 620-2058
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
100912
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100912
DEVICE DISTRIBUTOR LICENSE
TX
Enumeration date
06/29/2012
Last updated
06/29/2012
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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