MEDICARE: BAY AREA SLEEP EVALUATION CENTER, 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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1821033598
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAY AREA SLEEP EVALUATION CENTER, LLC

Provider Business Mailing Address
First Line	:	6000 S STAPLES ST STE 408
Second Line	:
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78413-2952
Country	:	US
Telephone Number	:	361-852-9200
Fax Number	:	361-852-9204

Provider Business Practice Location Address
First Line	:	6000 S STAPLES ST STE 408
Second Line	:
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78413-2952
Country	:	US
Telephone Number	:	361-852-9200
Fax Number	:	361-852-9204

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. ROXANNE VELA
Credential	:
Telephone Number	:	361-695-0007

Provider Enumeration Date	:	06/18/2006
Last Update Date	:	11/17/2020

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