Healthcare Provider Details

I. General information

NPI: 1144863812
Provider Name (Legal Business Name): ATX SLEEP CENTER OF AUSTIN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2019
Last Update Date: 07/20/2023
Certification Date: 07/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5920 W WILLIAM CANNON DR BLDG 6 STE 110
AUSTIN TX
78749
US

IV. Provider business mailing address

3200 STECK AVE SUITE 220
AUSTIN TX
78757
US

V. Phone/Fax

Practice location:
  • Phone: 512-238-7777
  • Fax:
Mailing address:
  • Phone: 512-238-7777
  • 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 Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. HAMID TODD TABDILI
Title or Position: ADMINISTRATOR
Credential: PHD
Phone: 310-270-7865