Provider Demographics
NPI:1467799601
Name:SLEEP APNEA ASSOCIATES OF TEXAS, PLLC
Entity Type:Organization
Organization Name:SLEEP APNEA ASSOCIATES OF TEXAS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORGANIZER
Authorized Official - Prefix:
Authorized Official - First Name:SHANE
Authorized Official - Middle Name:E
Authorized Official - Last Name:MATT
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:512-730-3623
Mailing Address - Street 1:200 MEDICAL PKWY
Mailing Address - Street 2:SUITE 270
Mailing Address - City:LAKEWAY
Mailing Address - State:TX
Mailing Address - Zip Code:78738-1782
Mailing Address - Country:US
Mailing Address - Phone:512-730-3623
Mailing Address - Fax:512-367-5841
Practice Address - Street 1:200 MEDICAL PKWY
Practice Address - Street 2:SUITE 270
Practice Address - City:LAKEWAY
Practice Address - State:TX
Practice Address - Zip Code:78738-1782
Practice Address - Country:US
Practice Address - Phone:512-730-3623
Practice Address - Fax:512-367-5841
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-08
Last Update Date:2013-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19858122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty