Provider Demographics
NPI:1457471815
Name:TOTAL SLEEP DIAGNOSTICS CONTRACT SERVICES
Entity Type:Organization
Organization Name:TOTAL SLEEP DIAGNOSTICS CONTRACT SERVICES
Other - Org Name:TOTAL SLEEP DIAGNOSTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AR DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BETSY
Authorized Official - Middle Name:
Authorized Official - Last Name:RIVAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-626-6211
Mailing Address - Street 1:4 SAINT ANN DR
Mailing Address - Street 2:
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70471-3265
Mailing Address - Country:US
Mailing Address - Phone:985-626-6211
Mailing Address - Fax:985-626-6227
Practice Address - Street 1:13284 POND SPRINGS RD
Practice Address - Street 2:STE 303
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78729-7177
Practice Address - Country:US
Practice Address - Phone:512-485-7150
Practice Address - Fax:512-485-7782
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
247200000X
TX0087156332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherGroup - Single Specialty
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX532126OtherBCBS PROVIDER NUMBER