Healthcare Provider Details

I. General information

NPI: 1992962724
Provider Name (Legal Business Name): TOTAL SLEEP DIAGNOSTICS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2008
Last Update Date: 10/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3613 WILLIAMS DR STE 803
GEORGETOWN TX
78628-1377
US

IV. Provider business mailing address

13284 POND SPRINGS RD STE 302
AUSTIN TX
78729-7177
US

V. Phone/Fax

Practice location:
  • Phone: 512-485-7150
  • Fax: 512-485-7782
Mailing address:
  • Phone: 512-485-7150
  • Fax: 512-485-7782

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1200X
TaxonomySleep 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