Provider Demographics
NPI:1700352150
Name:TEXAS SLEEP ASSOCIATES LLC
Entity Type:Organization
Organization Name:TEXAS SLEEP ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:KUPEC
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:512-930-7645
Mailing Address - Street 1:7600 W STATE HIGHWAY 29 STE 9
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78628-6938
Mailing Address - Country:US
Mailing Address - Phone:512-930-7645
Mailing Address - Fax:
Practice Address - Street 1:7600 W STATE HIGHWAY 29 STE 9
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78628-6938
Practice Address - Country:US
Practice Address - Phone:512-930-7645
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-23
Last Update Date:2018-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
1467460006OtherNPPES