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General NPI Number Information
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NPI Number | 1093112518
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Entity Type | Organization
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Legal Business Name | ACADEMY DIAGNOSTICS SLEEP CENTER, LLC
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Dates
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Enumeration Date | 11/26/2014
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Last Update Date | 11/26/2014
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Provider Practice Location Address
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Address Line | 12727 KIMBERLEY LN STE 107
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City | HOUSTON
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State | TX
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Zip | 77024-4047
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Country | US
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Telephone | 832-659-0248
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Fax | 832-659-0261
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Provider Business Mailing Address
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Address Line | 12727 KIMBERLEY LN STE 107
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City | HOUSTON
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State | TX
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Zip | 77024-4047
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Country | US
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Telephone | 832-659-0248
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Fax | 832-659-0261
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOSHUA ROTENBEG
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Credential | M.D.
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Telephone | 832-659-0248
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS1200X
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Taxonomy Name | Sleep Disorder Diagnostic Clinic/Center
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License Number |
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License Number State |
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