1558798520 NPI number — SOUND ASLEEP DME

Table of content: (NPI 1558798520)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558798520 NPI number — SOUND ASLEEP DME

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SOUND ASLEEP DME
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:
1558798520
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/04/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
519 N. KING ST
Provider Second Line Business Mailing Address:
STE. 104
Provider Business Mailing Address City Name:
SEGUIN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78155
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
830-433-9340
Provider Business Mailing Address Fax Number:
830-433-9343

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
519 N. KING ST
Provider Second Line Business Practice Location Address:
STE. 104
Provider Business Practice Location Address City Name:
SEGUIN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78155
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
830-433-9340
Provider Business Practice Location Address Fax Number:
830-433-9343
Provider Enumeration Date:
10/04/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
HONG
Authorized Official First Name:
SONG
Authorized Official Middle Name:
MIN
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
830-433-9340

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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