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General NPI Number Information
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NPI Number | 1467799601
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Entity Type | Organization
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Legal Business Name | SLEEP APNEA ASSOCIATES OF TEXAS, PLLC
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Dates
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Enumeration Date | 01/08/2013
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Last Update Date | 02/15/2013
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Provider Practice Location Address
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Address Line | 200 MEDICAL PKWY SUITE 270
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City | LAKEWAY
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State | TX
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Zip | 78738-1782
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Country | US
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Telephone | 512-730-3623
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Fax | 512-367-5841
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Provider Business Mailing Address
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Address Line | 200 MEDICAL PKWY SUITE 270
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City | LAKEWAY
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State | TX
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Zip | 78738-1782
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Country | US
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Telephone | 512-730-3623
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Fax | 512-367-5841
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Authorized Official
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Title or Position | ORGANIZER
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Name | SHANE E MATT
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Credential | DMD
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Telephone | 512-730-3623
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 19858
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License Number State | TX
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