MEDICARE: SNORING & FATIGUE CENTER

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

General Provider Information

NPI Number	:	1235507880
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SNORING & FATIGUE CENTER

Provider Business Mailing Address
First Line	:	11617 N CENTRAL EXPY
Second Line	:	SUITE 250
City	:	DALLAS
State	:	TX
Zip	:	75243-3800
Country	:	US
Telephone Number	:	469-726-2208
Fax Number	:

Provider Business Practice Location Address
First Line	:	11617 N CENTRAL EXPY
Second Line	:	SUITE 250
City	:	DALLAS
State	:	TX
Zip	:	75243-3800
Country	:	US
Telephone Number	:	469-726-2208
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	RAJDEEP KAKAR
Credential	:	M.D.
Telephone Number	:	469-726-2208

Provider Enumeration Date	:	09/11/2015
Last Update Date	:	09/11/2015

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