Lakeside Sleep Center LLC

Primary specialty

Sleep Disorder Diagnostic Clinic/CenterTaxonomy code 261QS1200X

Legal business name

LAKESIDE SLEEP CENTER LLC

Practice address

123 Blue Heron Dr
Ste 102
Montgomery, TX 77316-3192

Phone

(936) 582-1112

NPI assigned

Jan 10, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Cortnie Wellman

Title

Owner

Phone

(936) 582-1112

Specialties & licenses 2

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1484006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484006400000",
    "number": "1780120006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 BLUE HERON DR",
            "address_2": "STE 102",
            "city": "MONTGOMERY",
            "state": "TX",
            "postal_code": "773163192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 BLUE HERON DR",
            "address_2": "STE 102",
            "city": "MONTGOMERY",
            "state": "TX",
            "postal_code": "773163192",
            "telephone_number": "936-582-1112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE SLEEP CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-10",
        "last_updated": "2017-01-10",
        "status": "A",
        "authorized_official_last_name": "WELLMAN",
        "authorized_official_first_name": "CORTNIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "936-582-1112"
    },
    "taxonomies": [
        {
            "code": "261QS1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Sleep Disorder Diagnostic",
            "state": "TX",
            "license": null,
            "primary": true
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "TX",
            "license": "1000226",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lake Area Pediatrics
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• Lake Conroe Physical Therapy and Rehabilitation Services, Inc.
• Lakeside Pharmacy LLC
• Lakeside Pharmacy LLC
• Wilmot Lambert, RN
• Lcpdsmiles PLLC
• Tien Le, PHARMD
• Zuleika Leblanc, LM
• Legacy 5 House

• Sleep Disorder Diagnostic Clinic/Center in Montgomery, TX
• Providers in Montgomery, TX by specialty
• Sleep Disorder Diagnostic Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.