Provider Demographics
NPI:1386638195
Name:SLEEP INSTITUTE OF SAN ANTONIO, PA
Entity Type:Organization
Organization Name:SLEEP INSTITUTE OF SAN ANTONIO, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RAFAEL
Authorized Official - Middle Name:MANUEL
Authorized Official - Last Name:SANTIAGO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-492-1680
Mailing Address - Street 1:14855 BLANCO RD
Mailing Address - Street 2:SUITE 304
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-7732
Mailing Address - Country:US
Mailing Address - Phone:210-492-1680
Mailing Address - Fax:210-492-6693
Practice Address - Street 1:14855 BLANCO RD
Practice Address - Street 2:SUITE 304
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-7732
Practice Address - Country:US
Practice Address - Phone:210-492-1680
Practice Address - Fax:210-492-6693
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH5625261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
FTS032Medicare ID - Type Unspecified