1285234468 NPI number — SLOW WAVE, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285234468 NPI number — SLOW WAVE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SLOW WAVE, INC.
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:
1285234468
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/20/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
26100 COUNTRYSIDE DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SPICEWOOD
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78669-1362
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
210-379-6269
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
617 N US 281
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MARBLE FALLS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78654-5141
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
830-220-5700
Provider Business Practice Location Address Fax Number:
830-220-5701
Provider Enumeration Date:
10/28/2020

Additional Information

Authorized Official

Authorized Official Last Name:
WAGNER
Authorized Official First Name:
WAYNE
Authorized Official Middle Name:
R
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
281-787-5589

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332BC3200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 76041759786540000 . This is a "TRICARE EAST" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 901-51505 . This is a "BCBS AL" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 10078388 . This is a "CDRH FDA CLEARED SLOW WAVE, INC. SLOW WAVE DS8 ANTI-SNORING SLEEP APNEA" identifier . This identifiers is of the category "OTHER".
  • Identifier: NG92V . This is a "FLORIDA BLUE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 535244 . This is a "BCBS TX" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: K191320 . This is a "CDRH FDA CLEARED K191320 SLOW WAVE, INC. MEDICAL DEVICE SLOW WAVE DS8" identifier . This identifiers is of the category "OTHER".




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