MEDICARE: GALLERIA SLEEP DIAGNOSTICS, 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	261QS1200X	Sleep Disorder Diagnostic Clinic/Center

General Provider Information

NPI Number	:	1568785517
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GALLERIA SLEEP DIAGNOSTICS, LLC

Provider Business Mailing Address
First Line	:	3391 WESTPARK DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77005-4262
Country	:	US
Telephone Number	:	281-888-2727
Fax Number	:	281-664-3792

Provider Business Practice Location Address
First Line	:	3391 WESTPARK DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77005-4262
Country	:	US
Telephone Number	:	281-888-2727
Fax Number	:	281-664-3792

Authorized Official
Title or Position	:	OWNER
Name	:	MR. RAHUL DHAWAN
Credential	:
Telephone Number	:	832-667-8132

Provider Enumeration Date	:	03/04/2010
Last Update Date	:	03/04/2010

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