Provider Demographics
NPI:1033164876
Name:SLEEP MEDICINE ASSOCIATES OF TEXAS, PA
Entity Type:Organization
Organization Name:SLEEP MEDICINE ASSOCIATES OF TEXAS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:BURLIN
Authorized Official - Middle Name:LARRY
Authorized Official - Last Name:BREWER
Authorized Official - Suffix:
Authorized Official - Credentials:BA, RPSGT, RST
Authorized Official - Phone:214-750-7776
Mailing Address - Street 1:5477 GLEN LAKES DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-0946
Mailing Address - Country:US
Mailing Address - Phone:214-750-7776
Mailing Address - Fax:214-750-4621
Practice Address - Street 1:5477 GLEN LAKES DR
Practice Address - Street 2:SUITE 100
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-0946
Practice Address - Country:US
Practice Address - Phone:214-750-7776
Practice Address - Fax:214-750-4621
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX085376401Medicaid