Provider Demographics
NPI:1912230582
Name:TOTAL SLEEP DIAGNOSTICS, INC.
Entity Type:Organization
Organization Name:TOTAL SLEEP DIAGNOSTICS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:J
Authorized Official - Last Name:GUIDETTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-499-2857
Mailing Address - Street 1:1425 GREENWAY DR
Mailing Address - Street 2:STE 300
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75038-2447
Mailing Address - Country:US
Mailing Address - Phone:469-499-2857
Mailing Address - Fax:469-499-2806
Practice Address - Street 1:3200 COBB GALLERIA PKWY
Practice Address - Street 2:STE 245
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-5927
Practice Address - Country:US
Practice Address - Phone:770-818-9859
Practice Address - Fax:770-850-0832
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-14
Last Update Date:2009-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic