Provider Demographics
NPI:1063750420
Name:SLEEP MEDICINE INSTITUTE OF TEXAS, PA
Entity type:Organization
Organization Name:SLEEP MEDICINE INSTITUTE OF TEXAS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAGHAVENDRA
Authorized Official - Middle Name:V
Authorized Official - Last Name:GHUGE
Authorized Official - Suffix:
Authorized Official - Credentials:MD, D,ABSM
Authorized Official - Phone:903-787-7533
Mailing Address - Street 1:3187 PALUXY DR
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75701-8303
Mailing Address - Country:US
Mailing Address - Phone:903-787-7533
Mailing Address - Fax:903-787-8825
Practice Address - Street 1:3187 PALUXY DR
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-8303
Practice Address - Country:US
Practice Address - Phone:903-787-7533
Practice Address - Fax:903-787-8825
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-19
Last Update Date:2023-06-27
Deactivation Date:2023-04-12
Deactivation Code:
Reactivation Date:2023-06-27
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXAP139495OtherTEXAS BOARD OF NURSING