Healthcare Provider Details

I. General information

NPI: 1013305440
Provider Name (Legal Business Name): SLEEP TIGHT DIAGNOSTIC CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2015
Last Update Date: 06/10/2021
Certification Date: 06/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28533 SPRING TRAILS RDG STE 220
SPRING TX
77386-4355
US

IV. Provider business mailing address

28533 SPRING TRAILS RDG STE 220
SPRING TX
77386-4355
US

V. Phone/Fax

Practice location:
  • Phone: 832-791-4150
  • Fax: 832-663-9371
Mailing address:
  • Phone: 832-791-4150
  • Fax: 832-663-9371

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173F00000X
TaxonomySleep Specialist (PhD)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code246ZE0500X
TaxonomyEEG Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name: KIM HENRY
Title or Position: PARTNER
Credential:
Phone: 832-791-4150