MEDICARE: SLEEP MEDICINE CONSULTANTS OF CENTRAL TEXAS, PLLC

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	D0915	TX

General Provider Information

NPI Number	:	1962712091
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SLEEP MEDICINE CONSULTANTS OF CENTRAL TEXAS, PLLC

Provider Business Mailing Address
First Line	:	5508 PARKCREST DR
Second Line	:	SUITE 200
City	:	AUSTIN
State	:	TX
Zip	:	78731-4914
Country	:	US
Telephone Number	:	512-420-9900
Fax Number	:	512-420-9944

Provider Business Practice Location Address
First Line	:	5508 PARKCREST DR
Second Line	:	SUITE 200
City	:	AUSTIN
State	:	TX
Zip	:	78731-4914
Country	:	US
Telephone Number	:	512-420-9900
Fax Number	:	512-420-9944

Authorized Official
Title or Position	:	OWNER
Name	:	JOHN D HUDSON
Credential	:	MD
Telephone Number	:	512-420-9900

Provider Enumeration Date	:	10/07/2010
Last Update Date	:	06/16/2018

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