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General NPI Number Information
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NPI Number | 1518168582
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Entity Type | Organization
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Legal Business Name | AUSTIN SLEEP DIAGNOSTIC CENTER INC
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Dates
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Enumeration Date | 05/29/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1100 W 41ST ST
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City | AUSTIN
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State | TX
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Zip | 78756-3707
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Country | US
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Telephone | 512-323-9253
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Fax | 512-323-9254
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Provider Business Mailing Address
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Address Line | 4490 BELTWAY DR
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City | ADDISON
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State | TX
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Zip | 75001-3705
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Country | US
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Telephone | 800-961-9668
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Fax | 972-458-8224
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. KEN GOSSIP
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Credential |
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Telephone | 800-961-9668
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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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