Provider Demographics
NPI:1588072631
Name:SLUMBERLAND SEDATION LLC
Entity type:Organization
Organization Name:SLUMBERLAND SEDATION LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETER
Authorized Official - Prefix:MR
Authorized Official - First Name:LEONARD
Authorized Official - Middle Name:
Authorized Official - Last Name:SLANN
Authorized Official - Suffix:III
Authorized Official - Credentials:CRNA
Authorized Official - Phone:806-252-2571
Mailing Address - Street 1:5807 LLANO CT
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79707-3164
Mailing Address - Country:US
Mailing Address - Phone:806-252-2571
Mailing Address - Fax:
Practice Address - Street 1:5807 LLANO CT
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79707-3164
Practice Address - Country:US
Practice Address - Phone:806-252-2571
Practice Address - Fax:888-501-4807
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-31
Last Update Date:2014-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX86199367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty