| Sleep Dallas | |
|
3800 Gaylord Pkwy Ste 1190 Frisco TX 75034-9416 | |
| (844) 409-4657 | |
| Not Available |
| Full Name | Sleep Dallas |
|---|---|
| Speciality | Durable Medical Equipment & Medical Supplies |
| Location | 3800 Gaylord Pkwy Ste 1190, Frisco, Texas |
| Authorized Official Name and Position | B Kent Smith (OWNER) |
| Authorized Official Contact | 8444094657 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sleep Dallas 3800 Gaylord Pkwy Ste 1190 Frisco TX 75034-9418 Ph: (844) 409-4657 | Sleep Dallas 3800 Gaylord Pkwy Ste 1190 Frisco TX 75034-9416 Ph: (844) 409-4657 |
| NPI Number | 1790101020 |
|---|---|
| Provider Enumeration Date | 03/11/2014 |
| Last Update Date | 03/09/2022 |
| Medicare PECOS PAC ID | 3375713662 |
|---|---|
| Medicare Enrollment ID | O20140721001150 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790101020 | NPI | - | NPPES |
| 6543690001 | Other | TX | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 14695 (Texas) | Secondary |
| 332BC3200X | Durable Medical Equipment & Medical Supplies - Customized Equipment | (* (Not Available)) | Primary |
| Provider Name | Brady Smith |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1659418374 PECOS PAC ID: 4183894470 Enrollment ID: I20140721001221 |
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