Provider Demographics
NPI:1578961546
Name:KEY SLEEP STUDY, INC.
Entity Type:Organization
Organization Name:KEY SLEEP STUDY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:FONGUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-230-4727
Mailing Address - Street 1:12000 WILCREST DR
Mailing Address - Street 2:STE 204
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77031-1924
Mailing Address - Country:US
Mailing Address - Phone:832-230-4727
Mailing Address - Fax:832-230-4739
Practice Address - Street 1:12000 WILCREST DR
Practice Address - Street 2:STE 204
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77031-1924
Practice Address - Country:US
Practice Address - Phone:832-230-4727
Practice Address - Fax:832-230-4739
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-08
Last Update Date:2014-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory