Provider Demographics
NPI:1376542837
Name:GOOD NIGHT MEDICAL OF TEXAS, INC.
Entity Type:Organization
Organization Name:GOOD NIGHT MEDICAL OF TEXAS, INC.
Other - Org Name:GOOD NIGHT MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:J
Authorized Official - Last Name:CRAWFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-441-8876
Mailing Address - Street 1:1019 TOWN DR
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND HEIGHTS
Mailing Address - State:KY
Mailing Address - Zip Code:41076-9114
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10920 SWITZER AVE
Practice Address - Street 2:SUITE 106
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75238
Practice Address - Country:US
Practice Address - Phone:469-467-6555
Practice Address - Fax:614-386-0278
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GOOD NIGHT MEDICAL, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-07-18
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0077472332B00000X, 332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4605070001Medicare NSC