Provider Demographics
NPI:1659528552
Name:TEXAS CHRISTIAN CARE SLEEP CENTER, LLC
Entity Type:Organization
Organization Name:TEXAS CHRISTIAN CARE SLEEP CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRET
Authorized Official - Middle Name:MATHEW
Authorized Official - Last Name:WORLEY
Authorized Official - Suffix:
Authorized Official - Credentials:N/A
Authorized Official - Phone:361-739-5909
Mailing Address - Street 1:4455 S PADRE ISLAND DR
Mailing Address - Street 2:SUITE 6
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-5101
Mailing Address - Country:US
Mailing Address - Phone:361-723-2130
Mailing Address - Fax:361-723-2131
Practice Address - Street 1:4455 S PADRE ISLAND DR
Practice Address - Street 2:SUITE 6
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-5101
Practice Address - Country:US
Practice Address - Phone:361-723-2130
Practice Address - Fax:361-723-2131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-21
Last Update Date:2008-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic