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General NPI Number Information
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NPI Number | 1659644276
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Entity Type | Organization
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Legal Business Name | HEALTHY SLEEP TEXAS
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Dates
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Enumeration Date | 02/13/2012
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Last Update Date | 02/13/2012
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Provider Practice Location Address
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Address Line | 11623 ANGUS RD SUITE 16
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City | AUSTIN
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State | TX
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Zip | 78759
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Country | US
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Telephone | 512-346-5196
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Fax |
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Provider Business Mailing Address
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Address Line | 11623 ANGUS RD #16
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City | AUSTIN
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State | TX
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Zip | 78759
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Country | US
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Telephone | 512-346-1212
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Fax | 512-346-5320
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARC J WOROB
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Credential | D.D.S.
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Telephone | 512-346-5196
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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 | 9745
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 29960
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License Number State | TX
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