=====================================================
General NPI Number Information
=====================================================
NPI Number | 1386860948
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WESTCHASE SLEEP CENTER, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/18/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 11231 RICHMOND AVE STE. D104
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77082-6656
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-596-8880
-----------------------------------------------------
Fax | 281-596-8885
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 11231 RICHMOND AVE STE. D104
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77082-6656
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-596-8880
-----------------------------------------------------
Fax | 281-596-8885
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MR. SURAJUDEEN A AKOREDE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 281-596-8880
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225B00000X
-----------------------------------------------------
Taxonomy Name | Pulmonary Function Technologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------