Provider Demographics
NPI:1679798474
Name:SD PARTNERS, LLC
Entity type:Organization
Organization Name:SD PARTNERS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GERARD
Authorized Official - Middle Name:
Authorized Official - Last Name:JACOB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-500-6895
Mailing Address - Street 1:148 LEVEE PL
Mailing Address - Street 2:
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-2099
Mailing Address - Country:US
Mailing Address - Phone:972-899-3456
Mailing Address - Fax:888-433-6076
Practice Address - Street 1:4601 OLD SHEPARD PL STE 401
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5274
Practice Address - Country:US
Practice Address - Phone:214-500-6895
Practice Address - Fax:972-692-5420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-16
Last Update Date:2009-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic