Healthcare Provider Details

I. General information

NPI: 1871758433
Provider Name (Legal Business Name): 2920 SPRING SLEEP CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2008
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6225 FM 2920 SUITE 204
SPRING TX
77379-3464
US

IV. Provider business mailing address

6225 FM 2920 SUITE 204
SPRING TX
77379-3464
US

V. Phone/Fax

Practice location:
  • Phone: 281-378-4707
  • Fax: 281-378-4709
Mailing address:
  • Phone: 281-378-4707
  • Fax: 281-378-4709

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number StateTX

VIII. Authorized Official

Name: SUSHMA VEERA GORRELA
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 281-378-4707