=====================================================
General NPI Number Information
=====================================================
NPI Number | 1922577972
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PINACLE DIAGNOSTIC SLEEP CENTER
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/20/2018
-----------------------------------------------------
Last Update Date | 11/20/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6655 TRAVIS ST STE 850
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77030-1317
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-885-8824
-----------------------------------------------------
Fax | 281-886-3037
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 130940
-----------------------------------------------------
City | SPRING
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77393-0940
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 832-813-8280
-----------------------------------------------------
Fax | 800-500-2344
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGING MEMBER
-----------------------------------------------------
Name | STEVE ROPHAIL
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 713-679-4487
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 246ZA2600X
-----------------------------------------------------
Taxonomy Name | Medical Art Specialist/Technologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------