Healthcare Provider Details

I. General information

NPI: 1891265633
Provider Name (Legal Business Name): BAY BROOK SLEEP CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2018
Last Update Date: 12/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1235 CLEAR LAKE CITY BLVD STE E
HOUSTON TX
77062-8125
US

IV. Provider business mailing address

PO BOX 132904
SPRING TX
77393-2904
US

V. Phone/Fax

Practice location:
  • Phone: 281-661-8209
  • Fax: 281-661-1025
Mailing address:
  • Phone: 832-813-8280
  • Fax: 800-500-2344

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code246ZE0500X
TaxonomyEEG Specialist/Technologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code246ZA2600X
TaxonomyMedical Art Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name: STEVE ROPHAIL
Title or Position: MANAGING MEMBER
Credential:
Phone: 713-679-4487