Basic Information
| Provider Information | |||||||||
| NPI: | 1447587985 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | KATY SLEEP CENTER LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2569 | ||||||||
| Address2: | |||||||||
| City: | STAFFORD | ||||||||
| State: | TX | ||||||||
| PostalCode: | 774972569 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8002493478 | ||||||||
| FaxNumber: | 7135926772 | ||||||||
| Practice Location | |||||||||
| Address1: | 1820 S MASON RD # 350 | ||||||||
| Address2: | |||||||||
| City: | KATY | ||||||||
| State: | TX | ||||||||
| PostalCode: | 774506148 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8667572687 | ||||||||
| FaxNumber: | 8887572680 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/04/2009 | ||||||||
| LastUpdateDate: | 05/01/2013 | ||||||||
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| AuthorizedOfficialLastName: | ROSS | ||||||||
| AuthorizedOfficialFirstName: | DEBBIE | ||||||||
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| AuthorizedOfficialTitleorPosition: | DIRECTOR OF MANAGED CARE | ||||||||
| AuthorizedOfficialTelephone: | 2817727749 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QS1200X | N | Ambulatory Health Care Facilities | Clinic/Center | Sleep Disorder Diagnostic | 261QM1300X | Y | Ambulatory Health Care Facilities | Clinic/Center | Multi-Specialty |
No ID Information.