Healthcare Provider Details

I. General information

NPI: 1376542837
Provider Name (Legal Business Name): GOOD NIGHT MEDICAL OF TEXAS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2005
Last Update Date: 10/31/2024
Certification Date: 10/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6431 SOUTHWEST BLVD
BENBROOK TX
76132-2777
US

IV. Provider business mailing address

1019 TOWN DR
HIGHLAND HEIGHTS KY
41076-9114
US

V. Phone/Fax

Practice location:
  • Phone: 469-467-6555
  • Fax: 614-386-0278
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number0077472
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number0077472
License Number StateTX

VIII. Authorized Official

Name: GREGORY J CRAWFORD
Title or Position: CEO
Credential:
Phone: 859-441-8876