1922240142 NPI number — NATIONAL ASSOCIATES FOR SLEEP BEAUMONT,LLC

Table of content: (NPI 1346958626)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922240142 NPI number — NATIONAL ASSOCIATES FOR SLEEP BEAUMONT,LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NATIONAL ASSOCIATES FOR SLEEP BEAUMONT,LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1922240142
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/05/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2569
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
STAFFORD
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77497-2569
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-664-1330
Provider Business Mailing Address Fax Number:
713-664-3355

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3684 COLLEGE ST
Provider Second Line Business Practice Location Address:
SUITE A-1
Provider Business Practice Location Address City Name:
BEAUMONT
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77701-4616
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
866-757-2687
Provider Business Practice Location Address Fax Number:
888-757-2680
Provider Enumeration Date:
04/02/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BALAT
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
Authorized Official Title or Position:
MANAGED CARE DIRECTOR
Authorized Official Telephone Number:
713-664-1330

Provider Taxonomy Codes

  • Taxonomy code: 261QS1200X , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 293D00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0A5208 . This is a "MEDICARE" identifier . This identifiers is of the category "OTHER".