Provider Demographics
NPI:1144958273
Name:TEXAS STAR SLEEP APNEA AND TMJ CENTER, PLLC
Entity type:Organization
Organization Name:TEXAS STAR SLEEP APNEA AND TMJ CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:210-863-6331
Mailing Address - Street 1:21914 HARDY OAK BLVD APT 4305
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-5039
Mailing Address - Country:US
Mailing Address - Phone:210-863-6331
Mailing Address - Fax:210-757-3570
Practice Address - Street 1:14510 NW MILITARY HWY STE 105
Practice Address - Street 2:
Practice Address - City:SHAVANO PARK
Practice Address - State:TX
Practice Address - Zip Code:78231-1621
Practice Address - Country:US
Practice Address - Phone:210-863-6331
Practice Address - Fax:210-757-3570
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-08
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies