MEDICARE: TOTAL SLEEP HOLDINGS, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QS1200X	Sleep Disorder Diagnostic Clinic/Center

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	FTS121	OTHER	TX	MEDICARE DIAGNOSTIC PROVIDER NUMBER

General Provider Information

NPI Number	:	1013174705
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOTAL SLEEP HOLDINGS, INC

Provider Business Mailing Address
First Line	:	1425 GREENWAY DR
Second Line	:	STE 300
City	:	IRVING
State	:	TX
Zip	:	75038-2410
Country	:	US
Telephone Number	:	972-550-1203
Fax Number	:	972-550-1970

Provider Business Practice Location Address
First Line	:	1524 INDEPENDENCE PKWY
Second Line	:	STE J
City	:	PLANO
State	:	TX
Zip	:	75075-6406
Country	:	US
Telephone Number	:	972-596-9030
Fax Number	:	972-596-0830

Authorized Official
Title or Position	:	CEO
Name	:	WILLIAM J GUIDETTI
Credential	:
Telephone Number	:	469-499-2857

Provider Enumeration Date	:	05/20/2008
Last Update Date	:	07/30/2009

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