MEDICARE: NEXTGEN SLEEP LLC

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	207QS1201X	Sleep Medicine (Family Medicine) Physician	22192	OK

General Provider Information

NPI Number	:	1245605377
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEXTGEN SLEEP LLC

Provider Business Mailing Address
First Line	:	3414 NW 135TH ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73120-4009
Country	:	US
Telephone Number	:	405-753-6151
Fax Number	:	405-608-4110

Provider Business Practice Location Address
First Line	:	3418 NW 135TH ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73120-4009
Country	:	US
Telephone Number	:	405-753-6151
Fax Number	:	405-608-4110

Authorized Official
Title or Position	:	MANAGER
Name	:	MR. KARL BARRETO
Credential	:
Telephone Number	:	405-753-6151

Provider Enumeration Date	:	12/01/2015
Last Update Date	:	03/11/2020

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Directions to “NEXTGEN SLEEP LLC ” Practice Location

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