Provider Demographics
NPI:1659644276
Name:HEALTHY SLEEP TEXAS
Entity Type:Organization
Organization Name:HEALTHY SLEEP TEXAS
Other - Org Name:HEALTHY SLEEP AUSTIN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:J
Authorized Official - Last Name:WOROB
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:512-346-5196
Mailing Address - Street 1:11623 ANGUS RD #16
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759
Mailing Address - Country:US
Mailing Address - Phone:512-346-1212
Mailing Address - Fax:512-346-5320
Practice Address - Street 1:11623 ANGUS RD
Practice Address - Street 2:SUITE 16
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759
Practice Address - Country:US
Practice Address - Phone:512-346-5196
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-13
Last Update Date:2012-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX29960122300000X
TX9745122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty