MEDICARE: GULF COAST SLEEP CENTER AND DIAGNOSTICS 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	261QS1200X	Sleep Disorder Diagnostic Clinic/Center

General Provider Information

NPI Number	:	1508409707
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GULF COAST SLEEP CENTER AND DIAGNOSTICS LLC

Provider Business Mailing Address
First Line	:	107 W WAY ST STE 19
Second Line	:
City	:	LAKE JACKSON
State	:	TX
Zip	:	77566-5238
Country	:	US
Telephone Number	:	979-266-9497
Fax Number	:	979-266-9507

Provider Business Practice Location Address
First Line	:	107 W WAY ST STE 19
Second Line	:
City	:	LAKE JACKSON
State	:	TX
Zip	:	77566-5238
Country	:	US
Telephone Number	:	979-266-9497
Fax Number	:	979-266-9507

Authorized Official
Title or Position	:	OFFICE/BILLING MANAGER
Name	:	HOLLY WAGNER
Credential	:
Telephone Number	:	979-266-9497

Provider Enumeration Date	:	10/21/2019
Last Update Date	:	10/21/2019

Similar Medicare Providers

1184626467 — HOSPICE CARE TEAM, INC
Practice Location Address:

107 WEST WAY , SUITE 29
LAKE JACKSON, TX
77566-5238

Practice Phone: 979-297-6043
Practice Fax: 979-297-4752

1992177042 — GULF COAST MED SUPPLIES LLC
Practice Location Address:

107 W WAY ST STE 20
LAKE JACKSON, TX
77566-5238

Practice Phone: 979-266-9497
Practice Fax: 979-266-9507

1366708703 — MS. DEBRA BRYANT
Practice Location Address:

2527 JACKSON ST
ALEXANDRIA, LA
71301-5238

Practice Phone: 318-359-3730
Practice Fax:

1922093061 — TROPHY CLUB FAMILY MEDICINE PA
Practice Location Address:

301 TROPHY LAKE DR , #136
TROPHY CLUB, TX
76262-5238

Practice Phone: 817-430-9111
Practice Fax: 817-430-8911

1083605232 — DR. GUY P. COZZI PHARMD
Practice Location Address:

1417 LAKE COOK RD
DEERFIELD, IL
60015-5238

Practice Phone: 847-964-6250
Practice Fax:

1518948116 — DR. AMY PFEIFER PHARM.D.
Practice Location Address:

1417 LAKE COOK RD , MS L360
DEERFIELD, IL
60015-5238

Practice Phone: 847-964-6982
Practice Fax:

Directions to “GULF COAST SLEEP CENTER AND DIAGNOSTICS LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.