Provider Demographics
NPI:1861772675
Name:TEXAS SLEEP CLINIC - BT PLLC
Entity type:Organization
Organization Name:TEXAS SLEEP CLINIC - BT PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHEIF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:DONAGHUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-606-2727
Mailing Address - Street 1:13901 TECHNOLOGY DR
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73134-1052
Mailing Address - Country:US
Mailing Address - Phone:405-606-2727
Mailing Address - Fax:405-606-7040
Practice Address - Street 1:810 HOSPITAL DR STE 235
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77701-4654
Practice Address - Country:US
Practice Address - Phone:409-790-7841
Practice Address - Fax:409-813-2382
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-24
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXOOH54KOtherMEDICARE PTAN
DU8610OtherGROUP PTAN