MEDICARE: SLEEP DISORDER 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

General Provider Information

NPI Number	:	1710159769
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SLEEP DISORDER INC

Provider Business Mailing Address
First Line	:	2656 S LOOP W
Second Line	:	SUITE 570
City	:	HOUSTON
State	:	TX
Zip	:	77054-2664
Country	:	US
Telephone Number	:	713-790-1971
Fax Number	:

Provider Business Practice Location Address
First Line	:	2656 S LOOP W
Second Line	:	SUITE 570
City	:	HOUSTON
State	:	TX
Zip	:	77054-2664
Country	:	US
Telephone Number	:	713-790-1971
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MS. RAKHI VIRENDRAKUMAR DESAI
Credential	:
Telephone Number	:	281-731-3638

Provider Enumeration Date	:	03/31/2008
Last Update Date	:	03/31/2008

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