Healthcare Provider Details

I. General information

NPI: 1073084562
Provider Name (Legal Business Name): ATX SLEEP DOCS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2018
Last Update Date: 01/16/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 W PARMER LN STE 108
AUSTIN TX
78727-4111
US

IV. Provider business mailing address

3600 W PARMER LN STE 108
AUSTIN TX
78727-4111
US

V. Phone/Fax

Practice location:
  • Phone: 512-238-7777
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QS1201X
TaxonomySleep Medicine (Family Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: HAMID TODD TABDILI
Title or Position: ADMIN
Credential:
Phone: 310-270-7865