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General NPI Number Information
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NPI Number | 1376091470
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Entity Type | Organization
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Legal Business Name | CPAP GONE PLLC
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Dates
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Enumeration Date | 09/17/2016
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Last Update Date | 02/15/2017
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Provider Practice Location Address
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Address Line | 4309 HELSTON DR
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City | PLANO
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State | TX
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Zip | 75024-3737
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Country | US
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Telephone | 412-298-5460
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Fax |
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Provider Business Mailing Address
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Address Line | 7777 FOREST LN C-600
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City | DALLAS
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State | TX
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Zip | 75230-2571
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Country | US
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Telephone | 412-298-5460
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. TEENA WALI
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Credential | DDS
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Telephone | 412-298-5460
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number | 30793
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License Number State | TX
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