Provider Demographics
NPI:1922240142
Name:NATIONAL ASSOCIATES FOR SLEEP BEAUMONT,LLC
Entity Type:Organization
Organization Name:NATIONAL ASSOCIATES FOR SLEEP BEAUMONT,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGED CARE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:BALAT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-664-1330
Mailing Address - Street 1:PO BOX 2569
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77497-2569
Mailing Address - Country:US
Mailing Address - Phone:713-664-1330
Mailing Address - Fax:713-664-3355
Practice Address - Street 1:3684 COLLEGE ST
Practice Address - Street 2:SUITE A-1
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77701-4616
Practice Address - Country:US
Practice Address - Phone:866-757-2687
Practice Address - Fax:888-757-2680
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-02
Last Update Date:2009-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261QS1200X
293D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
No293D00000XLaboratoriesPhysiological Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
0A5208OtherMEDICARE