Provider Demographics
NPI:1477115830
Name:ABC SLEEP PLLC
Entity Type:Organization
Organization Name:ABC SLEEP PLLC
Other - Org Name:AUSTIN SLEEP AND WELLNESS CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SIREESHA
Authorized Official - Middle Name:
Authorized Official - Last Name:GOGINENI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-394-9468
Mailing Address - Street 1:5920 W WILLIAM CANNON DR STE 110
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78749-1902
Mailing Address - Country:US
Mailing Address - Phone:512-829-1137
Mailing Address - Fax:512-727-8994
Practice Address - Street 1:5920 W WILLIAM CANNON DR STE 110
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78749-1902
Practice Address - Country:US
Practice Address - Phone:512-829-1137
Practice Address - Fax:512-727-8994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-05
Last Update Date:2020-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Multi-Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty