Healthcare Provider Details
I. General information
NPI: 1417446436
Provider Name (Legal Business Name): FORESTWOOD SLEEP THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/04/2018
Last Update Date: 10/14/2022
Certification Date: 10/14/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
15836 CHAMPION FOREST DR
SPRING TX
77379-7141
US
IV. Provider business mailing address
15836 CHAMPION FOREST DR
SPRING TX
77379-7141
US
V. Phone/Fax
- Phone: 281-376-1101
- Fax:
- Phone: 281-376-1101
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332BC3200X |
| Taxonomy | Customized Equipment (DME) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KHOA
HUU
NGUYEN
Title or Position: DENTIST
Credential:
Phone: 281-376-1101