Provider Demographics
NPI:1922167584
Name:EASTEX SLEEP SOLUTIONS INC
Entity Type:Organization
Organization Name:EASTEX SLEEP SOLUTIONS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICAH
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:COOKSEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-892-8303
Mailing Address - Street 1:4037 EASTEX FREEWAY
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77706
Mailing Address - Country:US
Mailing Address - Phone:409-892-8303
Mailing Address - Fax:409-892-8306
Practice Address - Street 1:4037 EASTEX FREEWAY
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77706
Practice Address - Country:US
Practice Address - Phone:409-892-8303
Practice Address - Fax:409-892-8306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00075579OtherRR MEDICARE
3211020OtherAETNA
PL7087OtherBCBS
FTS046Medicare ID - Type Unspecified