Healthcare Provider Details
I. General information
NPI: 1881851350
Provider Name (Legal Business Name): TOTAL SLEEP DIAGNOSTICS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/21/2008
Last Update Date: 12/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
13284 POND SPRINGS RD STE 303
AUSTIN TX
78729-7177
US
IV. Provider business mailing address
1425 GREENWAY DR STE 300
IRVING TX
75038-2447
US
V. Phone/Fax
- Phone: 512-485-7150
- Fax: 512-485-7782
- Phone: 469-499-5249
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QS1200X |
| Taxonomy | Sleep Disorder Diagnostic Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
WILLIAM
J
GUIDETTI
Title or Position: CEO
Credential:
Phone: 469-499-2857