MEDICARE: FRONTIER SLEEP MANAGEMENT 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	173F00000X	Sleep Specialist (PhD)

General Provider Information

NPI Number	:	1417760307
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FRONTIER SLEEP MANAGEMENT LLC

Provider Business Mailing Address
First Line	:	4009 BANISTER LN STE 370
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78704-7040
Country	:	US
Telephone Number	:	512-215-4350
Fax Number	:	512-647-6367

Provider Business Practice Location Address
First Line	:	4009 BANISTER LN STE 370
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78704-7040
Country	:	US
Telephone Number	:	512-215-4350
Fax Number	:	512-647-6367

Authorized Official
Title or Position	:	ADMINISTRATIVE MANAGER
Name	:	NANCY CANTRELL
Credential	:
Telephone Number	:	512-215-4350

Provider Enumeration Date	:	01/27/2025
Last Update Date	:	06/01/2026

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