MEDICARE: TOTAL SLEEP DIAGNOSTICS, 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	:	1881851350
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOTAL SLEEP DIAGNOSTICS, INC.

Provider Business Mailing Address
First Line	:	1425 GREENWAY DR
Second Line	:	STE 300
City	:	IRVING
State	:	TX
Zip	:	75038-2447
Country	:	US
Telephone Number	:	469-499-5249
Fax Number	:

Provider Business Practice Location Address
First Line	:	13284 POND SPRINGS RD
Second Line	:	STE 303
City	:	AUSTIN
State	:	TX
Zip	:	78729-7177
Country	:	US
Telephone Number	:	512-485-7150
Fax Number	:	512-485-7782

Authorized Official
Title or Position	:	CEO
Name	:	WILLIAM J GUIDETTI
Credential	:
Telephone Number	:	469-499-2857

Provider Enumeration Date	:	05/21/2008
Last Update Date	:	12/17/2010

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