Healthcare Provider Details

I. General information

NPI: 1255718979
Provider Name (Legal Business Name): SIMPLE SLEEP SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2015
Last Update Date: 05/01/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1307 8TH AVE SUITE 404
FORT WORTH TX
76104-4137
US

IV. Provider business mailing address

17080 DALLAS PKWY
DALLAS TX
75248-1968
US

V. Phone/Fax

Practice location:
  • Phone: 469-685-1700
  • Fax: 888-491-6582
Mailing address:
  • Phone: 469-685-1700
  • Fax: 888-492-6582

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173F00000X
TaxonomySleep Specialist (PhD)
License Number13988
License Number StateTX

VIII. Authorized Official

Name: CHRIS PRINCE
Title or Position: PRESIDENT COO
Credential:
Phone: 469-685-1700