MEDICARE: SLEEP WAVE CENTER LLC

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	261Q00000X	Clinic/Center
2	261QS1200X	Sleep Disorder Diagnostic Clinic/Center

General Provider Information

NPI Number	:	1316583719
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SLEEP WAVE CENTER LLC

Provider Business Mailing Address
First Line	:	3400 BISSONNET ST STE 135
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77005-2163
Country	:	US
Telephone Number	:	832-426-4411
Fax Number	:	713-904-2585

Provider Business Practice Location Address
First Line	:	3400 BISSONNET ST STE 135
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77005-2163
Country	:	US
Telephone Number	:	832-426-4411
Fax Number	:	713-904-2585

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	GHASSAN A NOUREDDINE
Credential	:	MD
Telephone Number	:	832-426-4411

Provider Enumeration Date	:	11/20/2019
Last Update Date	:	11/20/2019

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Directions to “SLEEP WAVE CENTER LLC ” Practice Location

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