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General NPI Number Information
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NPI Number | 1699182618
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Entity Type | Organization
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Legal Business Name | MEDICAL CENTER SLEEP SOLUTIONS PLLC
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Dates
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Enumeration Date | 07/22/2014
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Last Update Date | 07/22/2014
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Provider Practice Location Address
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Address Line | 521 ORCHARD ST
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City | WEBSTER
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State | TX
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Zip | 77598-4109
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Country | US
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Telephone | 281-332-7565
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Fax | 281-332-0617
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Provider Business Mailing Address
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Address Line | 521 ORCHARD ST
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City | WEBSTER
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State | TX
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Zip | 77598-4109
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Country | US
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Telephone | 281-332-7565
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Fax | 281-332-0617
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Authorized Official
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Title or Position | OWNER
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Name | DR. CRYSTAL MARSHALL BRADY
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Credential | D.D.S.
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Telephone | 281-703-4115
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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 | 15127
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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 | 15127
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 15127
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 15127
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License Number State | TX
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