MEDICARE: COMPREHENSIVE SLEEP MEDICINE ASSOCIATES, PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084S0012X	Sleep Medicine (Psychiatry & Neurology) Physician	K7614	TX
2	2084N0600X	Clinical Neurophysiology Physician	K7614	TX
3	207QS1201X	Sleep Medicine (Family Medicine) Physician
4	2084N0400X	Neurology Physician	K7614	TX

General Provider Information

NPI Number	:	1114954443
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPREHENSIVE SLEEP MEDICINE ASSOCIATES, PA

Provider Business Mailing Address
First Line	:	PO BOX 16820
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77496-6820
Country	:	US
Telephone Number	:	281-240-3773
Fax Number	:	281-239-6268

Provider Business Practice Location Address
First Line	:	2201 W. HOLCOMBE
Second Line	:	SUITE 325
City	:	HOUSTON
State	:	TX
Zip	:	77030
Country	:	US
Telephone Number	:	713-668-4100
Fax Number	:	713-668-4105

Authorized Official
Title or Position	:	OWNER
Name	:	JERALD H SIMMONS
Credential	:	MD
Telephone Number	:	281-407-6222

Provider Enumeration Date	:	06/26/2006
Last Update Date	:	04/30/2014

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