Provider Demographics
NPI:1154480085
Name:SOUTH TEXAS SLEEP DISORDER CLINIC
Entity Type:Organization
Organization Name:SOUTH TEXAS SLEEP DISORDER CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:
Authorized Official - Last Name:MEYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-814-7464
Mailing Address - Street 1:1201 E RIDGE RD
Mailing Address - Street 2:SUITE E
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503-1531
Mailing Address - Country:US
Mailing Address - Phone:956-682-8685
Mailing Address - Fax:
Practice Address - Street 1:1201 E RIDGE RD
Practice Address - Street 2:SUITE E
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1531
Practice Address - Country:US
Practice Address - Phone:956-682-8685
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2011-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX218250301Medicaid
TXFTS238Medicare PIN