Organization
BRECK SLEEP LAB, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JILL L KIRK CRT (ADMINISTRATOR)
(254) 559-2023
Entity
Organization
Contact information
Practice address
203 S GENEVA ST, BRECKENRIDGE, TX 76424-4701
(254) 559-2023
(254) 559-9770
Mailing address
203 S GENEVA ST, BRECKENRIDGE, TX 76424-4701
(254) 559-2023
(254) 559-9770
Taxonomy
Speciality
Code
Description
License number
State
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PL7191
BLUE CROSS BLUE SHIELD
TX
Enumeration date
07/28/2006
Last updated
07/21/2008
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